First- and second-generation antipsychotics for children and young adults. Comparative Effectiveness Review No. 39. by JC Seida et al.
Surveys the entire research literature. The most important findings concern the research that does not exist!
NO studies of long-term effects, such as school completion, employment, early pregnancy, incarceration, or quality of life outcomes for medicated foster children.
NO studies to support that antipsychotic medications improve lives for children or adults.
NO studies on the efficacy of antipsychotic drugs as treatments for “conduct disorder” or “oppositional-defiant disorder” (“ODD”), although these diagnoses account for a large portion of all prescriptions for children.
GAO Foster Children Report
Details the high rates of psychtropic drug prescription among foster children in five states:
* “Thousands of foster and nonfoster children were prescribed doses exceeding maximum levels based on FDA-approved drug labels, which increases the potential for adverse side effects, and does not increase the efficacy of the drugs. Many of the drugs prescribed have not been approved for children by the FDA.”
* “Foster children were prescribed psychotropic drugs at higher rates than were nonfoster children in Medicaid.”
* “Foster children who change placements often do not have a consistent caretaker to plan treatment, offer consent, and provide oversight, which leads to gaps in care and nonadherence [not taking as prescribed].”
* 7.7% of foster children prescribed a psychotropic drug had three or more gaps in drug claims, likely representing episodes of abrupt withdrawal.
* “Nonadherence to drug regimens can pose significant risks to a patient, such as reduced efficacy from undertreatment, rebound of symptoms, and withdrawal symptoms.” Symptoms cited in the report include seizures, psychosis, weight gain, suicidal thoughts, nightmares, sleepiness, diabetes, dizziness, headaches, fatigue, decreased appetite, blurred vision, agitation, sexual dysfunction, high cholesterol, hallucinations, polycystic ovarian syndrome, kidney, thyroid, liver and pancreas damage, loss of coordination, and nausea.
* “Psychotropic drugs can have serious side effects in adults including irreversible movement disorders, seizures, and an increased risk for diabetes over the long term. Further, additional risks these drugs pose specifically to children are not well understood.”
* Many youth are prescribed more than one psychotropic drug. There is much anecdotal evidence that polypharmacy is risky, but there has been almost no research on the issue.