Medicaid’s cost for ADHD drugs rose dramatically in the past decade, mostly driven by off-label use of antipsychotics for ADHD in youth.

More info: The authors examined a large, state Medicaid database between 1996 and 2005to determine spending on medications for 107,486 children (3 to 17 years old) diagnosed with ADHD . Spending on stimulant medications increased 157% during this period due to increases in the price of prescriptions; during this time, there was a 588% increase in antipsychotic spending due to large increases in price and quantity used. From the...

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33% of children taking atomoxetine (brand name – Strattera) experienced extreme irritability, aggression, mania, or hypomania, and those with a family or personal history of mood disorder were especially likely to develop these symptoms.

More info: Authors reported on 153 sequential patients (average age 10.5 years old) treated with atomoxetine (brand name – Strattera) in outpatient settings in Denver, Colorado, and North Branch, Minnesota.  51 (33%) had psychiatric symptoms; of these 51 cases, 31 children (61%) also had a family history for mood disorders, 41 children (80%) had personal history of mood symptoms . From the source: “Our collective experience argues that...

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ADHD drugs can cause mania or psychotic symptoms in children and adolescents.

More info: The authors reviewed data from 49 children’s ADHD clinical trials for ADHD  and FDA cases report of ADHD-associated mania provided by drug manufacturers between 2000 and 2005.  In children’s clinical trials, there were 1.48 cases of psychosis/mania events per 100 person-years, with no comparable adverse events recorded in the placebo group. Out of more than 900 case reports (pediatric and adult) of symptoms of psychoses or...

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Mild-to-moderate sedation, extrapyramidal side effects (like drooling, blurry vision) and weight gain were the primary side effects experienced by a majority of youth taking antipsychotics.

More info: In this double-blind trial, 50 children between the ages of 8 and 19 years with psychotic symptoms were randomly assigned to treatment with olanzapine, risperidone or haloperidol (atypical antipsychotics). More than 50% of the children and adolescents experienced mild-to-moderate Parkinsonian symptoms and 2/19 youth treated with risperidone had severe Extra Pyramidal Side Effects [EPS]. Furthermore, a large proportion of patients...

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Children taking antipsychotics appear to be at a higher risk of adverse effects, including extrapyramidal symptoms, compared to adults.

More info: An expert panel was convened by the European College of Neuropsychopharmacology in 2008 in order to review the available clinical data regarding antipsychotic use in children and adolescents. The panel expressed concerns about rapid expansion of use of antipsychotics in children and brought attention to the need to weigh benefits and risks when prescribing these drugs because of the unknown long-term effects in younger patients...

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62% of youth taking antipsychotics for the first time experienced what the FDA defines as “abnormal weight gain.”

More info: Over a six year period (2001-2007) investigators identified 338 youth who had never taken antipsychotic medication. During the study, 272 children (aged 4-19 years) started with the antipsychotic Zyprexa, Risperdal, Seroquel, or Abilify (olanzapine, risperidone,  quetiapine , or aripiprazole). Researchers studied changes in weight, height, body-mass index, lipid and glucose levels, and insulin resistance in these youth. Body weight...

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