Skip to main content

Profiling psychotropic discharge medication from a children’s psychiatric ward

Abstract

Background Community prescribing of medication to treat psychiatric illness in children is increasing. However, details about medication prescribed at discharge from psychiatric inpatient services for children are scarce. Objectives Characterise the nature of psychotropic medication prescribed on discharge from a children’s psychiatric ward over a 15-year period. Method Retrospective analysis of discharge summary letters of all discharges occurring between Jan 1997 to Dec 2012. Results 234 children (152 males and 82 females) were discharged with 117 (50 %) prescribed psychotropic medication at discharge. 133 medicines were prescribed (stimulants n = 49, antipsychotics n = 31, antidepressants n = 22, mood stabilisers n = 1, other ADHD medication n = 11, melatonin n = 10, benzodiazepines n = 7, other n = 2). Risperidone was the most popular antipsychotic at a mean daily dose of 1 mg (range 0.25–4 mg). Fifty per cent were given an unlicensed medicine or a licensed drug was used in an unlicensed manner, of which risperidone was the most common (n = 14). Sleep disturbance and tics were most often treated using unlicensed/off label medication (n = 10). Conclusion Psychotropic medication is routinely used in inpatient children’s services, with the majority of use confined to stimulants and atypical antipsychotics. Much of the antipsychotic use is for unlicensed indications or at unlicensed doses.

This is a preview of subscription content, access via your institution.

References

  1. Doerry UA, Kent L. Prescribing practices of community child and adolescent psychiatrists. Psychiatrist. 2003;27:407–10.

    Google Scholar 

  2. Otasowie J, Duffy R, Freeman J, Hollis C. Antipsychotic prescribing practice among child psychiatrists and community paediatricians. Psychiatrist. 2010;34:126–9.

    Article  Google Scholar 

  3. Hsia Y, MacLennan K. Rise in psychotropic drug prescribing in children and adolescents during 1992–2001: a population-based study in the UK. Eur J Epidemiol. 2009;24:211–6.

    Article  PubMed  Google Scholar 

  4. Jacobs BW, Green J, Beecham J, Kroll L, Dunn G, Tobias C, et al. Two and a half thousand hours: the Children and Young Persons Inpatient Evaluation study (CHYPIE)into process and outcome of inpatient child and adolescent psychiatry. London: Department of Health; 2004.

    Google Scholar 

  5. Johnson J, Clark A. Prescribing of unlicensed medicines or licensed medicines for unlicensed applications in child and adolescent psychiatry. Psych Bull. 2001;25:465–6.

    Article  Google Scholar 

  6. Bloch MH, Panza KE, Landeros-Weisenberger A, Leckman JF. Meta-analysis: treatment of attention-deficit/hyperactivity disorder in children with comorbid tic disorders. J Am Acad Child Adolesc Psychiatry. 2009;48:884–93.

    PubMed Central  Article  PubMed  Google Scholar 

  7. National Institute for Health & Clinical Excellence (NICE). Attention deficit Hyperactivity Disorder: diagnosis and management of ADHD in children, young people and adults. Clinical Guideline No 72. http://publications.nice.org/attention-deficit-hyperactivity-disorder-cg72. Accessed Sept 2014.

  8. Corell CU. Antipsychotic use in children and adolescents:minimizing adverse effects to maximise outcomes. J Am Acad Child Adoles Psychiatry. 2008;47:9–20.

    Article  Google Scholar 

  9. Marder SR, Essock SM, Miller AL, Buchanan RW, Casey DE, Davis J, et al. Physical health monitoring of patients with schizophrenia. Am J Psychiatry. 2004;161:1334–49.

    Article  PubMed  Google Scholar 

  10. James A, Soler A, Weatherall R. Cognitive behavioural therapy for anxiety disorders in children and adolescents. Cochrane Database Syst Rev. 2005; 4:CD004690.

Download references

Acknowledgments

The author is grateful to G. Bailey and H. Allen for their help with data input and analysis.

Funding

No external funding was provided for this study.

Conflicts of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gazala Akram.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Akram, G. Profiling psychotropic discharge medication from a children’s psychiatric ward. Int J Clin Pharm 37, 753–757 (2015). https://doi.org/10.1007/s11096-015-0116-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-015-0116-1

Keywords

  • Antipsychotics
  • Child psychiatry
  • Psychotropic medication
  • Unlicensed indications
  • United Kingdom