Antipsychotic Medications Overprescribed For Everything, From Hyper Children To Nursing Home Residents

SEPTEMBER, 21  2013, Medical Daily – The overuse of antipsychotic medications has gained the attention of America’s doctors, as medical groups  add the drug class to a host of overused medical interventions including antibiotics and colonoscopies, among others.

The American Psychiatric Association (APA) this week launched an avalanche of public campaigning against the overuse of antipsychotics for treating everything from dementia to insomnia to pediatric behavioral problems, joined thus far by more than 50 medical groups. The APA published a new list of questionable uses for such medications as part of its “Choosing Wisely” campaign criticizing overuse of treatments, such as antibiotics for cold viruses and other inappropriate scenarios, contributing to the development of drug-resistant bacteria known as “superbugs.”

The APA says doctors frequently misuse older antipsychotic medications intended for conditions such as schizophrenia and bipolar disorder, as well as newer antipsychotics prescribed more frequently for behavioral problems in elderly nursing home residents and children with aggressive behaviors or attention deficit hyperactivity disorder.

Joel Yager, a psychiatry professor at the University of Colorado, Boulder, helped to develop the list for the APA. Physicians who overuse such medications act with good intentions and “are doing what they think might help,” he told USA Today. However, they should first try safer and more efficacious alternatives to these antipsychotic medications, he said.

The APA-led coalition of medical groups warns against the use of antipsychotics without full medical evaluations and continual monitoring. Doctors should also avoid prescribing the drugs in combination without first trying several medications first, using a strategy of trial and error. Antipsychotics should not be a first-line treatment. Common side effects of antipsychotics may include confusion, sedation, and early death. Also, children and teenagers with conditions other than psychotic disorders should not be given such medications, given research linking such drugs to weight gain, cardiovascular changes, and an increased risk of type 2 diabetes. Poor and minority children are most likely to receive such medications in the absence of a psychotic disorder, the APA says.

To that end, the U.S. Department of Health and Human Services is investigating the possible overuse of antipsychotic medications among children covered by Medicaid, The Wall Street Journal reported last month. Meanwhile, the U.S. Centers for Medicare & Medicaid Services says an earlier campaign to reduce such prescriptions among elderly people in nursing homes led to a 9 percent drop in the first year, as medical providers, government agencies, and the public banded together.

“This is a way to get the message out to the health community at large,” Yager said of the Choosing Wisely campaign.