Antipsychotics in child and adolescent patients with major depressive disorder: A retrospective analysis of prescribing patterns
Introduction Depression rates in children/adolescents in the United States have increased in the last 10 years. Fluoxetine and escitalopram are the only 2 antidepressants approved for the treatment of major depression disorder (MDD) in children/adolescents. In adults, some antipsychotics are approve...
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| Format: | Article |
| Language: | English |
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American Association of Psychiatric Pharmacists
2024-02-01
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| Series: | Mental Health Clinician |
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| Online Access: | https://theijpt.org/doi/pdf/10.9740/mhc.2024.02.010 |
| _version_ | 1797323996565340160 |
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| author | Danielle Dauchot, PharmD Suzanne Rettey, PharmD, MPA, BCPP Brittany L. Melton, PharmD, PhD Karen E. Moeller, PharmD, BCPP |
| author_facet | Danielle Dauchot, PharmD Suzanne Rettey, PharmD, MPA, BCPP Brittany L. Melton, PharmD, PhD Karen E. Moeller, PharmD, BCPP |
| author_sort | Danielle Dauchot, PharmD |
| collection | DOAJ |
| description | Introduction
Depression rates in children/adolescents in the United States have increased in the last 10 years. Fluoxetine and escitalopram are the only 2 antidepressants approved for the treatment of major depression disorder (MDD) in children/adolescents. In adults, some antipsychotics are approved for augmented treatment of MDD. However, there is limited research on antipsychotic augmentation in child/adolescent MDD.
Methods
This retrospective chart review evaluated antipsychotic prescribing for MDD in hospitalized patients aged 4 to 17 years to determine the frequency of prescribing antipsychotics for MDD and what factors influence the addition of an antipsychotic. For inclusion, patients were diagnosed with MDD and not on an antidepressant or antipsychotic before admission. Binomial logistic regression was used to analyze variables with prescribed antipsychotics as the dependent variable.
Results
There were 6.8% of patients prescribed an antipsychotic. Binomial logistic regression analysis found that increased age (odds ratio [OR] 1.28; 95% CI = 1.045, 1.568; P = .017) and multiple admissions within 1 year (OR 3.277; 95% CI = 2.283, 4.705; P < .001) were associated with the use of antipsychotics in patients with MDD. Posttraumatic stress disorder and disruptive mood dysregulation disorder were also associated with the use of antipsychotics.
Discussion
Careful consideration should be taken when using off-label antipsychotics in children due to limited studies on efficacy. Future research is warranted to assess the efficacy and safety of these agents in children and adolescents. |
| first_indexed | 2024-03-08T05:37:01Z |
| format | Article |
| id | doaj.art-9fa3c31c06ae4cbda80eb46816374778 |
| institution | Directory Open Access Journal |
| issn | 2168-9709 |
| language | English |
| last_indexed | 2024-03-08T05:37:01Z |
| publishDate | 2024-02-01 |
| publisher | American Association of Psychiatric Pharmacists |
| record_format | Article |
| series | Mental Health Clinician |
| spelling | doaj.art-9fa3c31c06ae4cbda80eb468163747782024-02-05T16:53:33ZengAmerican Association of Psychiatric PharmacistsMental Health Clinician2168-97092024-02-01141101610.9740/mhc.2024.02.010i2168-9709-14-1-10Antipsychotics in child and adolescent patients with major depressive disorder: A retrospective analysis of prescribing patternsDanielle Dauchot, PharmD0https://orcid.org/0009-0005-7253-5295Suzanne Rettey, PharmD, MPA, BCPP1https://orcid.org/0009-0001-7561-706XBrittany L. Melton, PharmD, PhD2https://orcid.org/0000-0002-6994-753XKaren E. Moeller, PharmD, BCPP3https://orcid.org/0000-0002-2863-83351 Psychiatric Pharmacy Practice Resident, Department of Pharmacy, University of Kansas Health System, Kansas City, Kansas2 2Psychiatric Clinical Pharmacist, Department of Pharmacy, University of Kansas Health System, Kansas City, Kansas3 Associate Professor, Associate Chair, Department of Pharmacy Practice, The University of Kansas School of Pharmacy, Lawrence, Kansas4 Clinical Professor, The University of Kansas School of Pharmacy, Department of Pharmacy Practice, Lawrence, KansasIntroduction Depression rates in children/adolescents in the United States have increased in the last 10 years. Fluoxetine and escitalopram are the only 2 antidepressants approved for the treatment of major depression disorder (MDD) in children/adolescents. In adults, some antipsychotics are approved for augmented treatment of MDD. However, there is limited research on antipsychotic augmentation in child/adolescent MDD. Methods This retrospective chart review evaluated antipsychotic prescribing for MDD in hospitalized patients aged 4 to 17 years to determine the frequency of prescribing antipsychotics for MDD and what factors influence the addition of an antipsychotic. For inclusion, patients were diagnosed with MDD and not on an antidepressant or antipsychotic before admission. Binomial logistic regression was used to analyze variables with prescribed antipsychotics as the dependent variable. Results There were 6.8% of patients prescribed an antipsychotic. Binomial logistic regression analysis found that increased age (odds ratio [OR] 1.28; 95% CI = 1.045, 1.568; P = .017) and multiple admissions within 1 year (OR 3.277; 95% CI = 2.283, 4.705; P < .001) were associated with the use of antipsychotics in patients with MDD. Posttraumatic stress disorder and disruptive mood dysregulation disorder were also associated with the use of antipsychotics. Discussion Careful consideration should be taken when using off-label antipsychotics in children due to limited studies on efficacy. Future research is warranted to assess the efficacy and safety of these agents in children and adolescents.https://theijpt.org/doi/pdf/10.9740/mhc.2024.02.010psychiatrychildrenadolescentsantipsychoticaugmentationmdd |
| spellingShingle | Danielle Dauchot, PharmD Suzanne Rettey, PharmD, MPA, BCPP Brittany L. Melton, PharmD, PhD Karen E. Moeller, PharmD, BCPP Antipsychotics in child and adolescent patients with major depressive disorder: A retrospective analysis of prescribing patterns Mental Health Clinician psychiatry children adolescents antipsychotic augmentation mdd |
| title | Antipsychotics in child and adolescent patients with major depressive disorder: A retrospective analysis of prescribing patterns |
| title_full | Antipsychotics in child and adolescent patients with major depressive disorder: A retrospective analysis of prescribing patterns |
| title_fullStr | Antipsychotics in child and adolescent patients with major depressive disorder: A retrospective analysis of prescribing patterns |
| title_full_unstemmed | Antipsychotics in child and adolescent patients with major depressive disorder: A retrospective analysis of prescribing patterns |
| title_short | Antipsychotics in child and adolescent patients with major depressive disorder: A retrospective analysis of prescribing patterns |
| title_sort | antipsychotics in child and adolescent patients with major depressive disorder a retrospective analysis of prescribing patterns |
| topic | psychiatry children adolescents antipsychotic augmentation mdd |
| url | https://theijpt.org/doi/pdf/10.9740/mhc.2024.02.010 |
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