Among privately insured young children, antipsychotic use declined from 2009 to 2017, according to a study published online Oct. 19 in the Journal of the American Academy of Child & Adolescent Psychiatry.

Greta A. Bushnell, Ph.D., from Rutgers University in New Brunswick, New Jersey, and colleagues used data from a nationwide commercial claims database (2007 to 2017) to examine trends in annual antipsychotic medication use by privately insured U.S. young children (ages 2 to 7 years).

The researchers found that annual antipsychotic use in young children was 0.27% in 2007, peaked at 0.29% in 2009, and significantly declined to 0.17% by 2017 (linear trend: −0.017% per year). Boys had higher antipsychotic use than girls. More antipsychotic users received a mental disorder diagnosis in 2017 (89%) than 2009 (86%), with the most common clinical diagnoses being pervasive developmental disorder (2009: 27%; 2017: 38%), conduct or disruptive behavior disorder (2009: 15%; 2017: 21%), and attention-deficit/hyperactivity disorder (2009: 24%; 2017: 18%). In 2017, 32% of antipsychotic users had four or more psychotherapy claims, 43% had a psychiatrist visit, and the majority used another psychotropic medication, most commonly a stimulant (boys: 57%; girls: 50%).

"Despite continued prescribing, there is limited evidence for the efficacy of antipsychotics for conduct or disruptive behavior disorders in very young children and the long-term outcomes remain poorly understood," Bushnell said in a statement.