Medication prescribing in children has been increasing worldwide and as a result the rate polypharmacy as well as off label prescribing in Child and Adolescent psychiatry became common practice rather than an exception.

The aim of this audit was to evaluate the prescribing trends, the use of polypharmacy, and use of unlicensed medications in Central Manchester District Child and Adolescent Mental health (CAMHS) service as well as to compare those rates were possible to the rates found in 2005 audit.

We reviewed all case notes open to Child and Adolescent psychiatry department between March-June 2011 and data were collected using special proforma covering general demographic data, diagnosis and medication used. Data were analysed using descriptive and inferential statistical methods using SPSS 16.0.

Our results showed a general increase in use of pharmacological treatments from 19% in 2005 to 44% in 2011 (172 out of 388), with the rate of polypharmacy of 30% in 2011. the main symptom triggering use of additional medication was insomnia especially in those on stimulant medication. the rate of medications used outside their license was 44% and it did not change from that found in 2005 (46%).

The results of this audit confirmed earlier findings showing increase in psychotropic prescribing, polypharmacy and of ‘off label’ medication use in children. Thus it is important to emphasise the need of thorough documentation and close monitoring for side effects in this population.