Among all patients taking the new generation of antipsychotic medication, children are most likely to suffer severe weight gain and metabolic disturbances. But the use of these drugs to treat children has seen steady, steep growth.
Between 1990 and 2000, prescriptions for children and adolescents grew 160%, according to a 2005 study; other studies show they continued to grow briskly through the early 2000s.
Virtually all of that prescribing has been off-label. Among the atypical antipsychotics, only risperidone (marketed as Risperdal) has been approved by the Food and Drug Administration for use by children diagnosed with schizophrenia. In June, the FDA will consider a petition by AstraZeneca for permission to promote the use of Seroquel by adolescents (ages 13 to 17) with schizophrenia and younger kids (11 to 17) with bipolar disorder.
As the drugs have become more widely prescribed, however, many physicians have become increasingly alarmed.
"We have optimism based, I think, on intense marketing," says Julie M. Zito, a University of Maryland researcher who has led several studies documenting the growth of antipsychotic use in children. "We're all searching for better drugs, all searching for magic bullets. But we all need to wake up here and be alert. The problems are real."
In November, an expert panel advising the FDA on pediatric drug safety sounded the klaxon over the rising use of atypical antipsychotics among kids, and faulted the FDA for failing to issue warnings strong enough to stem the tide.
Dr. Leon Dure, a pediatric neurologist from the University of Alabama's School of Medicine, complained that physicians prescribing the drugs to children may not appreciate the side effects, including weight gain and movement disorders. "This committee is frustrated," Dure said. "And we need to find a way to accommodate this concern."
melissa.healy@.latimes.com
