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Psychotropic prescribing patterns among adolescents in Northern Ireland presenting with psychotic symptoms during a 5-year period

Published online by Cambridge University Press:  10 April 2015

G. Woods ,
C. Shannon ,
G. Davidson ,
K. Hoy ,
D. Lewis ,
L. Tumelty  and
C. Mulholland
G. Woods*
Affiliation:
Ards Community Hospital, Church Street, Newtownards, BT23 4AS, United Kingdom
C. Shannon
Affiliation:
Ards Community Hospital, Church Street, Newtownards, BT23 4AS, United Kingdom
G. Davidson
Affiliation:
Ards Community Hospital, Church Street, Newtownards, BT23 4AS, United Kingdom
K. Hoy
Affiliation:
Ards Community Hospital, Church Street, Newtownards, BT23 4AS, United Kingdom
D. Lewis
Affiliation:
Ards Community Hospital, Church Street, Newtownards, BT23 4AS, United Kingdom
L. Tumelty
Affiliation:
Ards Community Hospital, Church Street, Newtownards, BT23 4AS, United Kingdom
C. Mulholland
Affiliation:
Ards Community Hospital, Church Street, Newtownards, BT23 4AS, United Kingdom
*
*Address for correspondence: Dr G. Woods, Consultant Psychiatrist, Ards Community Hospital, Church Street, Newtownards, BT23 4AS, United Kingdom. (Email: gary.woods@setrust.hscni.net)
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Abstract

Objective

To report new prescriptions of psychotropic medications among adolescents presenting with new onset psychotic symptoms during a 5-year period.

Methods

The Northern Ireland Early Onset Psychosis Study is a naturalistic longitudinal observational study of patients with an early onset first psychotic episode. All patients aged <18 years presenting to specialist mental health services across Northern Ireland with new onset psychotic symptoms between 2001 and 2006 were recruited (n=113). Clinical case notes were analysed retrospectively for details of subsequent treatment with psychotropic medications.

Results

A total of 100 patients (88.5%) were prescribed some form of psychotropic medication. Over three-quarters of patients received an antipsychotic as their first medication. Risperidone (45.8%), olanzapine (24.0%) and chlorpromazine (12.5%) were the most commonly prescribed first-line antipsychotic medications. Of a total of 160 antipsychotic prescriptions, 81 (50.6%) were off-label. Prescriptions were most likely to have been deemed off-label owing to medications not being licensed in under-18s (71.6% of off-label prescriptions) but other reasons were medications being used outside licensed age ranges (23.5%) and outside licensed indications (4.9%).

Conclusions

This is the first study examining psychotropic prescribing patterns in a complete sample of all children and adolescents presenting with early onset psychotic episodes in a single geographical area. The observation of risperidone as the most commonly prescribed antipsychotic was in keeping with previous studies in child and adolescent populations. Rates of off-label prescribing were lower than previously observed although our study was the first to investigate off-label prescribing solely in children and adolescents presenting with psychotic symptoms.

Keywords

Adolescentsantipsychoticschildrenoff-labelpsychosispsychotropics
Type
Original Research
Information
Irish Journal of Psychological Medicine , Volume 33 , Issue 1 , March 2016 , pp. 13 - 20
Copyright
© College of Psychiatrists of Ireland 2015 

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