Majority of Youth Prescribed Antipsychotics Have No Psychiatric Diagnosis

Justin Karter
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The majority of children, adolescents and young adults prescribed antipsychotic medications have not been diagnosed with a mental disorder, according to a recent study published in JAMA Psychiatry.  The study, led by Mark Olfson from Columbia University, examined trends in the treatment of young people with antipsychotics in the United States between 2006 and 2010 and raised concerns about the safety and efficacy of prescription practices.

“Most of the younger children (60.0%), older children (56.7%), adolescents (62.0%), and young adults (67.1%) treated with antipsychotics had no outpatient or inpatient claim that included a mental disorder diagnosis,” the study said.

Among those who did receive a diagnosis for a mental disorder, the study raised the additional concern that antipsychotics had not been FDA approved for treatment.  Although the FDA has approved the use of antipsychotics for diagnoses such as schizophrenia and bipolar disorder, many children, teens and young adults are prescribed these medications off-label.  In children and adolescents treated with antipsychotics the most common accompanying diagnoses are ADHD and depression.

The authors advise that the frequency with which antipsychotic medications are being prescribed by non-psychiatrists may point to potential gaps in treatment for children presenting for mental health care.  This finding was especially concerning for preschool aged children who were found to be in the age group least likely to receive antipsychotic prescriptions from a psychiatrist.

Clinical guidelines suggest extreme caution in the use of antipsychotic medications with young children.  Due to the possibility of serious side-effects, antipsychotics are suggested only in the most severe cases and should be paired with psychosocial interventions. Of those prescribed antipsychotic medications, however, only 13.5 % of younger children, 20.4% of older children, 24.8% of adolescents and 18.8% of young adults were found to have a claim for psychotherapy.

The study’s lead author, Dr. Olson, commented:

“Relatively few of these young people are receiving psychotherapy. We may need to put greater effort into increasing access to psychosocial interventions that can treat symptoms and behaviors that are currently being addressed with antipsychotic medications.” (Source)

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Olfson M, King M, Schoenbaum M. Treatment of young people with antipsychotic medication in the US. JAMA Psychiatry.(Full Text)

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16 COMMENTS

  1. Of course, they are also creating a lot of the symptoms themselves with medication side effects, especially of stimulants and SSRI antidepressants. I can’t tell you how many foster kids I’ve seen who started out on stimulants for “ADHD” and ended up on antipsychotics because it made them aggressive or manic. It always appalls me how incredibly irresponsible this prescribing is, and believe me, it’s NOT because non-psychiatrists are prescribing – psychiatrists do this all the time, and I almost never hear of them taking a kid off of something because the side effects are making him/her more aggressive or agitated.

    It’s a monster of their own creation.

    — Steve

    • The so called ADHD is also in 99% of cases acute hyper vigilance, a symptom of PTSD due to the abuse and trauma they have suffered, and which the child protection system only compounds. But yes, when the med’s do not do what we want and they experience side effects we just add in another chemical cocktail to the mix. The numbers of kids on multiple medications is beyond me.

      The first thing Paediatricians do in most cases when they diagnose young children with Autism is to put them on anti psychotics, some as young as 18 months of age. Many have not even displayed any behavioural problems, they are withdrawn and non responsive, but we place them on anti-psychotics to prevent them developing behavioural problems!! Then we wonder why they appear to become more and more intellectually and cognitively disabled!!

  2. This is the case with adults over the age of twenty-five years, also. It is very terrible for these young people because their minds, bodies, and spirits are still growing and they are so vulnerable. But, it is dangerous for those who are older than twenty-five years old, also. Basically, these toxic, addictive, evil drugs (they are absolutely not any kind of medications; despite all the “med reviews” they subject you through) destroy people. There is much talk about the evil selling of baby parts by Planned Parenthood and it is horribly evil and it Hitler-ish and against God. Yet, the drugging of children and adults with the toxic, addictive, deadly drugs is also along the same horrific, Hitler-like lines also. Unfortunately; we have yet a real advocate organization like the Center for Medical Progress; an anti-abortion, right to life organization. We need an organization on our behalf to stop this wholesale onslaught upon the children and adults of this world and their illegally and horrifically stealing their minds, bodies, and souls and making them into living zombies and vegetables. You see, tragically, the spirit of Hitler is alive and is up to us to defeat him and get our lives and our children back. Thank you.

    • @rebel While I fully believe that we could benefit from a strong advocacy organization, the Center for Medical Progress is not the sort of organization I want any part of. Their reports of Planned Parenthood selling body parts from aborted fetuses is a made up hoax designed to influence the public and law makers into defunding Planned Parenthood. This is the same type of hoax that was perpetrated against ACORN. This type of tactic is something I want nothing to do with.

  3. This is a long standing issue. It has been going on since, from my knowledge, the 1970’s. Behavior issues for the family, foster family, school, or hospital trump all. I think it started out innocently enough but warped into a “Clockwork Orange” scenario.
    Fritz Redl ‘s work is no longer in English on Wikipedia only in German. He was a big advocate for children and the whole concept of therapeutic milieu. This whole idea of creating an atmosphere where growth and recovery can happen has been thrown out the window by various powers that be. Men in dark suits!
    What hasn’t been mentioned on this site is the rise of MBA’s in medical and other type of organizations. Young adults with no front line in the trenches experience were given power and control over programs they had no moral right to administer.
    Children and adults fell through the widening cracks.
    Families were told untruths and the whole system is crashing to the ground. I really hope that like the Phoenix beautiful things will grow out of the ashes. Dreaming is okay isn’t it?

  4. While I hope to see a day when people look back at this type of debate just as they would now at historic quarrels between schools of alchemy, I do wonder…

    Implied in the heading is the assumption that things would be institutionally kosher once those kids had some kind of official “diagnosis.” In other words they need to be categorized, dehumanized AND drugged, yeah, that would be better.

  5. I live in small town Southern America and one of the joys of such living is a local cable station with delightful, non politically or allegedly objectively correct news. One thing they do each weeknight is report the local crime news of approximately four or five adjacent counties. When it comes to drug arrests, I have noticed in addition to the arrests for marijuana, cocaine, and methamphetamine; there are usually arrests for some having a type of controlled substance that is actually a prescription drug (I guess most probably stolen, gotten from false drug prescriptions and sometimes with an intent to sell) These arrests not only include the usual addictive opiate painkillers (oxycoton, etc. ) ; but, also psychiatric prescription drugs. Thus, if these drugs are supposed to be so good for you or a young person and help you with whatever is ailing you, then why are these people getting arrested for having them and why are they trying to sell them. Although, I do question diabetes drugs, ant-cholesterol drugs, etc, and others, I never hear of any arrests in regards to these drugs. I know there are a whole lot of bad drugs out there for all kind of diseases that can afflict the human body. Yet, on the whole no one is arrested for having those drugs in their possession with intent to sell or by having too many pills than allowed or whatever they arrest these people for. Now, that I think of this. I have read about this in the papers for over twenty years and even though, I took some of these drugs; a little voice inside me was quietly and then noisily nagging me. If these drugs are so safe and beneficial to you; why do people get arrested for having them? Just a question to ponder tonight. Thank you.

  6. And regarding this, ““Relatively few of these young people are receiving psychotherapy. We may need to put greater effort into increasing access to psychosocial interventions that can treat symptoms and behaviors that are currently being addressed with antipsychotic medications.”

    Isn’t it incredible to hear the most obvious things stated by psychiatrists as if they were key insights or an elephant not already in the room?… Well, I guess some people really don’t have their eyes open.

  7. No, they don’t have diagnoses because before going on the drugs, they’re fine.

    Given a few months on antipsychotics, though, and they qualify for a bunch of “psychiatric diagnoses” as well as a few physical ones – keeps the doctors and the drug companies in business!

    That’s why psychiatrists have to keep coming up with new diagnoses – firstly to keep doctors and drug companies in business and secondly to make sure they classify side effects as official illnesses so no-one realises that it’s all iatrogenic.