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Trends in Prescribing Antipsychotics for Children and Adolescents in Japan: A Descriptive Epidemiological Study Using a Large-Scale Pharmacy Dataset

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Abstract

Little is known about antipsychotic prescription patterns among children and adolescents in Japan, particularly in outpatient settings. We investigated the prevalence and trends of antipsychotic prescription for outpatients aged ≤ 17 years receiving a first antipsychotic prescription from 2006 to 2012 based on a large-scale dispensation dataset. Measurements included age, sex, department of diagnosis and treatment, type of prescription (monotherapy or polytherapy), antipsychotic dosage, and concomitant psychotropic drugs. Of the 10,511 patients, 65.1% were aged 13–17 years, and 52.9% were males. Second-generation antipsychotic monotherapy prescriptions increased from 53.8% in 2006 to 78.3% in 2012. Risperidone was the most frequently prescribed antipsychotic, followed by aripiprazole and olanzapine. Approximately 25.0% of patients were prescribed an initial dose less than recommended. Second-generation antipsychotic monotherapy is currently the most frequent prescription pattern among outpatients aged ≤ 17 years receiving an initial antipsychotic prescription.

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Acknowledgements

We acknowledge Ain Holdings Inc. and Kraft Inc. for the generous provision of pharmacy claims data. We thank Jennifer Barrett, Ph.D., from Edanz Group for editing a draft of this manuscript.

Funding

This study was supported by the Sponsored Research Program administered by Kyoto University and Sumitomo Dainippon Pharma.

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Authors and Affiliations

  1. Department of Pharmacoepidemiology, Kyoto University Graduate School of Medicine and Public Health, Yoshidakonoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan

    Sayuri Nakane, Sachiko Tanaka-Mizuno, Chika Nishiyama, Kenji Kochi, Madoka Yamamoto-Sasaki, Masato Takeuchi & Koji Kawakami

  2. Department of Digital Health and Epidemiology, Kyoto University Graduate School of Medicine and Public Health, Kyoto, Japan

    Sachiko Tanaka-Mizuno

  3. Department of Critical Care Nursing, Kyoto University Graduate School of Human Health Science, Kyoto, Japan

    Chika Nishiyama

  4. Drug Development Division, Sumitomo Dainippon Pharma Co., Ltd, Tokyo, Japan

    Kenji Kochi

  5. Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Yusuke Ogawa

  6. Ain Holdings Inc, Sapporo, Hokkaido, Japan

    Yuko Doi & Yosuke Fujii

  7. Kraft Inc, Chiyoda, Tokyo, Japan

    Masaru Arai & Toshiyuki Matsunaga

  8. Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine and School of Public Health, Kyoto, Japan

    Toshiaki A. Furukawa

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  1. Sayuri Nakane
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Corresponding author

Correspondence to Koji Kawakami.

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Conflicts of interest

Sayuri Nakane, Sachiko Tanaka-Mizuno, Madoka Yamamoto-Sasaki, Masato Takeuchi, Chika Nishiyama, and Yusuke Ogawa declare that they have no conflicts of interest. Kenji Kochi is an employee at Sumitomo Dainippon Pharma. has received honoraria from Eli Lilly. Toshiaki A. Furukawa reports grants and personal fees from Mitsubishi-Tanabe, personal fees from MSD, grants and personal fees from Shionogi, outside the submitted work; In addition, TAF has a patent 2020-548587concerning smartphone CBT apps pending, and intellectual properties for Kokoro-app licensed to Mitsubishi-Tanabe. Koji Kawakami has received research funds from Eisai Co. Ltd.; Kyowa Kirin Co. Ltd.; Sumitomo Dainippon Pharma Co. Ltd.; Pfizer Inc.; Stella Pharma Corporation; CMIC Co. Ltd.; Suntory Beverage & Food Ltd.; Mitsubishi Corporation, and Real World Data Co. Ltd.; consulting fees from LEBER Inc.; JMDC Inc.; Shin Nippon Biomedical Laboratories Ltd.; Kaken Pharmaceutical Co. Ltd.; and Advanced Medical Care Inc.; executive compensation from Cancer Intelligence Care Systems; Inc.; honorarium from Mitsubishi Chemical Holdings Corporation, Mitsubishi Corporation, and Pharma Business Academy; and holds stock in Real World Data Co. Ltd..

Ethical Approval

This study was approved by the Ethics Committees of Kyoto University Graduate School of Medicine (registration number E1897). All procedures were conducted according to the Declaration of Helsinki. In addition, all procedures performed in studies involving human participants were following the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Nakane, S., Tanaka-Mizuno, S., Nishiyama, C. et al. Trends in Prescribing Antipsychotics for Children and Adolescents in Japan: A Descriptive Epidemiological Study Using a Large-Scale Pharmacy Dataset. Child Psychiatry Hum Dev 54, 1250–1257 (2023). https://doi.org/10.1007/s10578-022-01330-x

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