European Child & Adolescent Psychiatry

, Volume 24, Issue 6, pp 635–640 | Cite as

Recent international trends in psychotropic medication prescriptions for children and adolescents

  • Hans-Christoph SteinhausenEmail author
Original Contribution


Prescriptions of psychotropic medications have become an important intervention for many children and adolescents with mental disorders, and the rise of these prescriptions is debated intensively both among experts and the public. This review reports some recent international findings on point prevalence rates, cross-country comparisons, and time trends in psychotropic medication prescriptions for children and adolescents. Besides the total prescription rates, figures for antidepressants, antipsychotics, stimulants, and anxiolytics prescriptions are provided. The overall prescription rates of psychotropics in general and the major medication subgroups prescribed to children and adolescents vary substantially between countries with the US consumption being markedly higher than the use in European countries. However, even among the latter there are marked variations in findings. Studies reporting on time trends clearly indicate that there was a marked increase in the use of psychotropics for children and adolescents in the recent past. However, only a single study adjusted prevalence rates for the increasing number of children and adolescents assessed and treated in institutions providing mental health care. Considering the increasing numbers of children and adolescents seen in psychiatric services, the increase of psychotropic medications is less strong though still pronounced enough to stimulate further reflections on the use of these interventions.


Psychopharmacology Stimulants Antidepressants Antipsychotics Anxiolytics Children Adolescents 


Conflict of interest

H.-C. Steinhausen has worked in the past as an advisor and speaker for the following pharmaceutical companies: Janssen-Cilag, Eli Lilly, Novartis, Medice, Shire, and UCB. More than three years ago, he has also received unrestricted grants for postgraduate training courses or conferences and research by Janssen-Cilag, Eli Lilly, Novartis, Medice, and Swedish Orphan International.


  1. 1.
    Rapoport JL (2013) Pediatric psychopharmacology: too much or too little? World Psychiatry 12:118–123CrossRefPubMedCentralPubMedGoogle Scholar
  2. 2.
    Steinhausen HC (2013) A European perspective on paedo-psychiatric pharmacoepidemiology. World Psychiatry 12:131–132CrossRefPubMedCentralPubMedGoogle Scholar
  3. 3.
    Taylor E (2013) Pediatric psychopharmacology: too much and too little. World Psychiatry 12:124–125CrossRefPubMedCentralPubMedGoogle Scholar
  4. 4.
    Mancini J, Thirion X, Masut A, Saillard C, Pradel V, Romain F, Pastor MJ, Coudert C, Micallef J (2006) Anxiolytics, hypnotics, and antidepressants dispensed to adolescents in a French region in 2002. Pharmacoepidemiol Drug Saf 15:494–503CrossRefPubMedGoogle Scholar
  5. 5.
    Zoega H, Baldursson G, Hrafnkelsson B, Almarsdottir AB, Valdimarsdottir U, Halldorsson M (2009) Psychotropic drug use among Icelandic children: a nationwide population-based study. J Child Adolesc Psychopharmacol 19:757–764CrossRefPubMedGoogle Scholar
  6. 6.
    Olfson M, He JP, Merikangas KR (2013) Psychotropic medication treatment of adolescents: results from the national comorbidity survey-adolescent supplement. J Am Acad Child Adolesc Psychiatry 52:378–388CrossRefPubMedCentralPubMedGoogle Scholar
  7. 7.
    Wong IC, Murray ML, Camilleri-Novak D, Stephens P (2004) Increased prescribing trends of paediatric psychotropic medications. Arch Dis Child 89:1131–1132CrossRefPubMedCentralPubMedGoogle Scholar
  8. 8.
    Zito JM, Safer DJ, de Jong-van den Berg LT, Janhsen K, Fegert JM, Gardner JF, Glaeske G, Valluri SC (2008) A three-country comparison of psychotropic medication prevalence in youth. Child Adolesc Psychiatry Ment Health 2:26 1753-2000-2-26CrossRefPubMedCentralPubMedGoogle Scholar
  9. 9.
    Zito JM, Safer DJ, DosReis S, Gardner JF, Magder L, Soeken K, Boles M, Lynch F, Riddle MA (2003) Psychotropic practice patterns for youth: a 10-year perspective. Arch Pediatr Adolesc Med 157:17–25CrossRefPubMedGoogle Scholar
  10. 10.
    Hugtenburg JG, Heerdink ER, Egberts AC (2004) Increased psychotropic drug consumption by children in the Netherlands during 1995-2001 is caused by increased use of methylphenidate by boys. Eur J Clin Pharmacol 60:377–379CrossRefPubMedGoogle Scholar
  11. 11.
    Steinhausen HC, Bisgaard C (2014) Nationwide time trends in dispensed prescriptions of psychotropic medication for children and adolescents in Denmark. Acta Psychiatr Scand 129:221–231CrossRefPubMedGoogle Scholar
  12. 12.
    Percudani M, Barbui C, Fortino I, Petrovich L (2005) Worrying patterns of out-patient psychotropic drug prescribing in children and adolescents. Psychother Psychosom 74:189–190CrossRefPubMedGoogle Scholar
  13. 13.
    Zito JM, Tobi H, de Jong-van den Berg LT, Fegert JM, Safer DJ, Janhsen K, Hansen DG, Gardner JF, Glaeske G (2006) Antidepressant prevalence for youths: a multi-national comparison. Pharmacoepidemiol Drug Saf 15:793–798CrossRefPubMedGoogle Scholar
  14. 14.
    Murray ML, de Vries CS, Wong IC (2004) A drug utilisation study of antidepressants in children and adolescents using the General Practice Research Database. Arch Dis Child 89:1098–1102CrossRefPubMedCentralPubMedGoogle Scholar
  15. 15.
    Vitiello B, Zuvekas SH, Norquist GS (2006) National estimates of antidepressant medication use among US children, 1997–2002. J Am Acad Child Adolesc Psychiatry 45:271–279CrossRefPubMedGoogle Scholar
  16. 16.
    Olfson M, Marcus SC (2009) National patterns in antidepressant medication treatment. Arch Gen Psychiatry 66:848–856CrossRefPubMedGoogle Scholar
  17. 17.
    Fegert JM, Kolch M, Zito JM, Glaeske G, Janhsen K (2006) Antidepressant use in children and adolescents in Germany. J Child Adolesc Psychopharmacol 16:197–206CrossRefPubMedGoogle Scholar
  18. 18.
    Dorks M, Langner I, Dittmann U, Timmer A, Garbe E (2013) Antidepressant drug use and off-label prescribing in children and adolescents in Germany: results from a large population-based cohort study. Eur Child Adolesc Psychiatry 22:511–518CrossRefPubMedGoogle Scholar
  19. 19.
    Deurell M, Weischer M, Pagsberg AK, Labianca J (2008) The use of antipsychotic medication in child and adolescent psychiatric treatment in Denmark. A cross-sectional survey. Nord J Psychiatry 62:472–480CrossRefGoogle Scholar
  20. 20.
    Rani F, Murray ML, Byrne PJ, Wong IC (2008) Epidemiologic features of antipsychotic prescribing to children and adolescents in primary care in the United Kingdom. Pediatrics 121:1002–1009CrossRefPubMedGoogle Scholar
  21. 21.
    Olfson M, Blanco C, Liu L, Moreno C, Laje G (2006) National trends in the outpatient treatment of children and adolescents with antipsychotic drugs. Arch Gen Psychiatry 63:679–685CrossRefPubMedGoogle Scholar
  22. 22.
    Pringsheim T, Lam D, Patten SB (2011) The pharmacoepidemiology of antipsychotic medications for Canadian children and adolescents: 2005–2009. J Child Adolesc Psychopharmacol 21:537–543CrossRefPubMedGoogle Scholar
  23. 23.
    Patel NC, Sanchez RJ, Johnsrud MT, Crismon ML (2002) Trends in antipsychotic use in a Texas medicaid population of children and adolescents: 1996 to 2000. J Child Adolesc Psychopharmacol 12:221–229CrossRefPubMedGoogle Scholar
  24. 24.
    Zoega H, Furu K, Halldorsson M, Thomsen PH, Sourander A, Martikainen JE (2011) Use of ADHD drugs in the Nordic countries: a population-based comparison study. Acta Psychiatr Scand 123:360–367CrossRefPubMedGoogle Scholar
  25. 25.
    Zito JM, Safer DJ, DosReis S, Gardner JF, Boles M, Lynch F (2000) Trends in the prescribing of psychotropic medications to preschoolers. JAMA 283:1025–1030CrossRefPubMedGoogle Scholar
  26. 26.
    Zuvekas SH, Vitiello B (2012) Stimulant medication use in children: a 12-year perspective. Am J Psychiatry 169:160–166CrossRefPubMedCentralPubMedGoogle Scholar
  27. 27.
    Visser SN, Danielson ML, Bitsko RH, Holbrook JR, Kogan MD, Ghandour RM, Perou R, Blumberg SJ (2014) Trends in the parent-report of health care provider-diagnosed and medicated attention-deficit/hyperactivity disorder: United States, 2003–2011. J Am Acad Child Adolesc Psychiatry 53:34–46CrossRefPubMedGoogle Scholar
  28. 28.
    Schirm E, Tobi H, Zito JM, de Jong-van den Berg LT (2001) Psychotropic medication in children: a study from the Netherlands. Pediatrics 108:E25CrossRefPubMedGoogle Scholar
  29. 29.
    Knellwolf AL, Deligne J, Chiarotti F, Auleley GR, Palmieri S, Boisgard CB, Panei P, Autret-Leca E (2008) Prevalence and patterns of methylphenidate use in French children and adolescents. Eur J Clin Pharmacol 64:311–317CrossRefPubMedGoogle Scholar
  30. 30.
    Schubert I, Koster I, Lehmkuhl G (2010) The changing prevalence of attention-deficit/hyperactivity disorder and methylphenidate prescriptions: a study of data from a random sample of insurees of the AOK Health Insurance Company in the German State of Hesse, 2000–2007. Dtsch Arztebl Int 107:615–621PubMedCentralPubMedGoogle Scholar
  31. 31.
    Zetterqvist J, Asherson P, Halldner L, Langstrom N, Larsson H (2013) Stimulant and non-stimulant attention deficit/hyperactivity disorder drug use: total population study of trends and discontinuation patterns 2006–2009. Acta Psychiatr Scand 128:70–77CrossRefPubMedGoogle Scholar
  32. 32.
    Dalsgaard S, Nielsen HS, Simonsen M (2013) Five-fold increase in national prevalence rates of attention-deficit/hyperactivity disorder medications for children and adolescents with autism spectrum disorder, attention-deficit/hyperactivity disorder, and other Psychiatric disorders: a Danish register-based study. J Child Adolesc Psychopharmacol 23:432–439CrossRefPubMedCentralPubMedGoogle Scholar
  33. 33.
    Vitiello B (2008) An international perspective on pediatric psychopharmacology. Int Rev Psychiatry 20:121–126CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Research Unit for Child and Adolescent Psychiatry, Aalborg Psychiatric HospitalAalborg University HospitalAalborgDenmark
  2. 2.Clinical Psychology and Epidemiology, Department of PsychologyUniversity of BaselBaselSwitzerland
  3. 3.Department of Child and Adolescent PsychiatryUniversity of ZurichZurichSwitzerland

Personalised recommendations