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Lesley H. Curtis, PhD; Leah E. Masselink; Truls Østbye, MD, PhD; Steve Hutchison, PhD; Peter E. Dans, MD; Alan Wright, MD; Ranga R. Krishnan, MB, ChB; Kevin A. Schulman, MD

Arch Pediatr Adolesc Med. 2005;159:362-366.

Background  Use of atypical antipsychotic medications in pediatric populations is increasing. Although previous studies have presented data by age or sex, none has documented sex-specific prevalence by age group.

Objective  To estimate the 1-year prevalence of atypical antipsychotic use by age and sex among commercially insured youths in the United States.

Design  Period prevalence study, January through December 2001.

Setting  Administrative claims database of a large pharmaceutical benefit manager for 6 213 824 outpatients.

Main Outcome Measures  Period prevalence of outpatient prescription claims for atypical antipsychotic drugs among commercially insured, continuously enrolled youths.

Results  The prevalence of atypical antipsychotic use was 267.1 per 100 000 subjects aged 19 years and younger (16 599/6 213 824) and was more than twice as high for male patients as for female patients, although male and female patients were nearly equally represented in the overall population. Prevalence peaked at 594.3 per 100 000 subjects among male patients aged 10 to 14 years and 291.0 per 100 000 subjects among female patients aged 15 to 19 years. Nearly one fourth (3830/16 599) of patients with a claim for an atypical antipsychotic were aged 9 years and younger, and nearly 80% of these (3021/3830) were boys.

Conclusions  Although evidence regarding the safety and efficacy of atypical antipsychotics in young children is limited, nearly one fourth of patients with claims for these drugs were aged 9 years or younger, and a large majority of these were boys. Understanding the long-term effects on the developing brain of early and prolonged exposure to atypical antipsychotics is crucial given their use in pediatric populations.

Author Affiliations: Center for Clinical and Genetic Economics, Duke Clinical Research Institute (Drs Curtis and Schulman and Ms Masselink), and Departments of Community and Family Medicine (Dr Østbye) and Psychiatry and Behavioral Sciences (Dr Krishnan), Duke University Medical Center, Durham, NC; AdvancePCS, Scottsdale, Ariz (Dr Hutchison); and AdvancePCS Clinical Services, Hunt Valley, Md (Drs Dans and Wright). Ms Masselink is now with the University of North Carolina School of Public Health, Chapel Hill.

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