Effect of antipsychotic drugs on children needs investigation, B.C. researcher says

There is no evidence of a direct cause-and-effect relationship in statistics showing the number of youth who die while taking antipsychotics, but there is reason to be concerned and investigate, says a B.C. researcher.

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Constadina Panagiotopoulos, a pediatric endocrinologist at B.C. Children’s Hospital, co-authored a peer-reviewed study published Monday that looked at trends in prescribing potent psychiatric drugs for toddlers to teens in B.C., from 1996 to 2011. It found an exponential rise in prescriptions of antipsychotics to youth by family doctors, pediatricians and psychiatrists.

Panagiotopoulos says there are no studies supporting increased mortality on these drugs. The drugs are considered suspect, but it would be hard to tease out the information to find a cause as the patients may have had other health issues and been on other drugs and treatments.

The Health Canada statistics of adverse events including death are “just a red flag that requires further study,” Panagiotopoulos said.

Health Canada says its responsibility is to oversee that products marketed in Canada are safe, effective and of high quality, when used for the approved recommended conditions of use.

It has been monitoring the safety of antipsychotics — including adverse drug reaction reports, peer-reviewed scientific studies and information from drug manufacturers and international regulatory agencies, said spokewoman Blossom Leung, in a statement.

“Physicians have a responsibility to assess the benefits and risks of the product for each individual patient they treat,” she said, in an email.

The following are Health Canada statistics on adverse reactions to antipsychotics prescribed to youth in Canada from January 1, 1996, to December 31, 2011, as reported to the Canada Vigilance Program (where an age was reported).

First Generation antipsychotics:

(including: chlorpromazine, droperidol, flupenthixol, fluphenazine, haloperidol, mesoridazine, perhpenazine, pimozide, prochlorperazine, promethazine, thioridazine, thiothixene, trifluoperazine, and zuclopenthixol )

Age 0-5 years: 8 adverse reaction reports - none died.

Age 6-12 years: 8 adverse reaction reports - 2 died.

Age 13-18 years: There were a total of 13 adverse reaction reports - no deaths

Second Generation antipsychotics:

(including aripiprazole, clozapine, olanzapine, paliperidone, quetiapine, risperidone, and ziprasidone)

Age 0-5 years: 58 cases (33 were for exposure in utero or via breast-feeding) — 4 died.

Age 6-12 years: 96 cases — 2 died.

Age 13-18 years: 220 cases —10 of whom died.

Source: Health Canada

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