Foster Kids Often Prescribed Antipsychotic Drug Cocktails, Study Finds

Foster kids are now among the vulnerable groups being treated with antipsychotic drugs, according to a new study. We’ve long written about the drugs being used to quiet the elderly in nursing homes, where the drugs are prescribed off-label.

Now, it seems that foster children are being prescribed what The New York Times described as “cocktails of powerful antipsychosis drugs” with the same regularity as some seriously mentally disabled Medicaid pediatric patients. The study appears in the journal Pediatrics, and is the first of its kind to look at how children in foster care are treated with two antipsychotics at one time, including Risperdal, Seroquel, and Zyprexa.

“The kids in foster care may come from bad homes, but they do not have the sort of complex medical issues that those in the disabled population do…. We simply don’t have evidence to support this kind of use, especially in young children,” said Susan dosReis, associate professor at the University of Maryland’s School of Pharmacy and the study’s lead author, wrote the Times.

We recently wrote that antipsychotics are approved for serious psychiatric conditions; however, the drugs can be used at physician discretion and are being used for a range of disorders. Some of these other uses have seen recent approval by the U.S. Food and Drug Administration (FDA); many have not.

We’ve long explained that such drugs are approved to treat schizophrenia and bipolar disorder; however, they are often used off-label to treat vulnerable populations, such as seniors with dementia, despite that these drugs carry a black box warning that elderly people treated in this way have an increased risk of death. Although atypical antipsychotics are being used more and more for an array of off-label conditions, the drugs are only effective for a few such diagnoses.

Another study reviewing prior Zyprexa, Abilify, Risperdal, and Seroquel research suggests that while atypical antipsychotics are used for a number of off-label diagnoses, the drugs are not effective for most and there is a variance in benefits and adverse reactions, according to a prior Journal of the American Medical Association (JAMA) article.

The Times points out that physicians and politicians are worried about the increase in psychiatric drug use, in general, in the foster care system, especially given that this system involves 400,000 to 500,000 children and adolescents. Previous studies have found that children in foster care receive psychiatric medications at about twice the rate among children outside the system.

The study revealed that about 2% of foster children studied were being treated with at least one antipsychotic, despite that the conditions for which these drugs are prescribed—schizophrenia and bipolar disorder—are uncommon in young children, said The Times.

The study involved a review of 2003 Medicaid records for 637,924 minors from an unnamed state in the mid-Atlantic and who were in foster care and receiving disability benefits for specific diagnoses, such as severe autism or bipolar disorder, or who were enrolled in the Temporary Assistance for Needy Families program, said The Times. The programs utilize Medicaid funding.

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