Experts caution against the increasing rates of prescribing psychotropic drugs to children and young people as the primary method for managing mental health issues, highlighting the limited evidence supporting such practices.
These drugs include sedatives, anti-anxiolytics, antidepressants, antipsychotics, and melatonin. The researchers stress the need for safer prescribing practices, given the potential risks associated with these medications.
The editorial points out a concerning trend: the number of psychotropic drugs prescribed to young people has been steadily rising, often for extended periods.
They reference studies indicating a significant annual increase in antipsychotic prescriptions for children between 2000 and 2019 and a doubling of antidepressant prescriptions among 12-17-year-olds from 2005 to 2017.
Additionally, there was a dramatic rise in melatonin prescriptions for under-17s, with over 56,000 children taking the drug in 2022—a 168% increase from 2015.
The issue is not isolated to the UK. Data from a large US household survey reveal a similar trend of rising psychotropic prescriptions among young people, despite growing concerns about the safety and effectiveness of this approach.
The editorialists highlight that the safety of these drugs in children is inadequately researched, prompting the American Academy of Child and Adolescent Psychiatry to recommend cautious prescribing practices, especially for vulnerable groups such as children in foster care.
The editorial underscores the necessity of regular review and timely discontinuation of psychotropic medications. However, evidence suggests that primary care clinicians often lack the confidence to taper these drugs, and hospital doctors feel constrained by the short duration of inpatient stays, which hampers the initiation of dose reduction.
To make psychotropic prescribing safer, the editorialists call for a better understanding of the associated risks, appropriate dosing for different age groups, and mandatory physical health monitoring.
They advocate for improved oversight and collaborative decision-making involving young people and their families to ensure that medications are not continued unnecessarily. This approach is essential for aligning treatment with the best interests of the patients.
