Friday, November 21, 2008

#1 Diagnosis for Antipsychotic Drugs?

Antipsychotic drugs are not just used "a lot" for "ADHD".

Usually "ADHD" is the top diagnosis (or near the top) when psychiatrists prescribe antipsychotic drugs.

Treating ADHD In Maine

By Ed Silverman
November 20, 2008

Earlier this week, the FDA advisory committee slammed the rising use of antipsychotics in youngsters, particularly to treat attention deficit disorders. The meds, you see, were approved by the agency for schiozphrenia or bipolar disorder - and only recently for youngsters, in some cases (back story).

The trend, however, to prescribe these meds for teenagers and children has actually been widespread, with Medicaid programs in several states reporting rising expenditures for antipsychotics to treat ADD or ADHD. A report issued last year by the University of South Florida found that among children 5 years or younger, 53.8 percent were prescribed antipsychotics for a diagnosis of ADHD. The figure was 48.8 percent for children between 6 and 12 years old (see page 22).

The issue is gaining attention because the meds can cause weight gain and metabolic disorders, and the FDA committee complained current warnings are insufficient. The meds include Johnson & Johnson’s Risperdal, Lilly’s Zyprexa, AstraZeneca’s Seroquel, Bristol-Myers Squibb’s Abilify and Pfizer’s Geodon. As we have written previously, a consortium of state Medicaid directors is evaluating the use of the drugs in children to ensure they are being properly prescribed (take a look).

And now we have another example. In Maine, spending by the state Medicaid program on each of the five widely prescribed antipsychotics has been rising for children 18 years and younger since 2000, except for Zyprexa. At the same time, ADHD has been the number one diagnosis among the same population each year, except for last year, when prolonged post-traumatic stress disorder was more widely diagnosed. See the chart. The data is courtesy of the Office of Maine Care Services.

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