Troubling trends in prescribing for children

Background: Off-label prescribing occurs when a practitioners prescribes a medication for either a condition or a population for which a regulatory body has not granted approval. Off-label prescribing can come with unintended negative consequences, such as safety concerns.Methods: We used systematic review methods to identify psychotropics being prescribed for young people in Canada. We then compared how these prescription practices align with the best available research evidence regarding the use of psychotropics in children and youth.Results: The data revealed striking increases in the number of antipsychotic prescriptions written and dispensed for young people with risperidone, quetiapine and olanzapine being prescribed most frequently. We also found that these medications were often prescribed for conditions, such as depression and anxiety disorders, for which there was neither regulatory approval nor high quality research evidence to support their use.Conclusions: Off-label psychiatric prescribing comes with many risks. To help remedy this situation, more high-quality pediatric medication trials and more robust monitoring of drug safety are required.