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Antipsychotic drug prescriptions nearly double for kids with ADHD

NASHVILLE While parents, schools and physicians still struggle with the perceived overuse of the medication Ritalin to treat children with attention difficulties, a new study suggests the potential for another controversy. Researchers at the Monroe Carell Jr. Children's Hospital at Vanderbilt (Vanderbilt Children's Hospital) have found a new class of antipsychotic medications is being prescribed for an increasing number of TennCare children with attention deficit/hyperactivity disorder (ADHD).

The study, published in the August 3 issue of Archives of Pediatric Adolescent Medicine, revealed that between 1996 and 2001 the proportion of children on TennCare, Tennessee's program for Medicaid enrolles and the uninsured, who were new users of powerful atypical antipsychotic medications almost doubled, from 23 per 10,000 children to 45 per 10,000. Use for behavioral problems associated with attention-deficit/hyperactivity disorder (ADHD) and mood disorders increased more than twofold. Perhaps most concerning, the adolescent population had more than a threefold increase in use of the drugs for ASDHD/conduct disorder, that amounted to nearly one in every 100 adolescents covered under TennCare.

The study's authors, led by William Cooper, M.D., associate professor of Pediatrics at Children's Hospital, tracked medical records of thousands of children listed in Tennessee's managed care program between 1996 and 2001. They eliminated any child listed with a severe disability, including a severe mental illness like psychosis or autism. The team suspects the concerns extend to the entire population and have started working with CDC records in a new study to determine the problem's extent.

Cooper and Catherine Fuchs, M.D., associate professor of Psychiatry at Vanderbilt, began noticing an increasing number of children in Vanderbilt's clinics who were on antipsychotic drugs. In 2001, Cooper and Fuchs began the retrospective research.

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