Table_1_New Users of Antipsychotics Among Children and Adolescents in 2008–2017: A Nationwide Register Study.xlsx

IntroductionRecently, prescribing antipsychotics for children and adolescents has been increasing in many countries. These drugs are often prescribed off-label, although antipsychotics have been associated with adverse effects. We determined the recent incidence of antipsychotic use among children and adolescents in Finland.MethodsFinnish National Prescription Register including all Finnish inhabitants receiving reimbursement for pharmaceuticals was searched for subjects of 1 to 17 years of age who had started an antipsychotic drug between January 1, 2008, and December 31, 2017 (n = 26,353). Between 2008 and 2017, the range of number of Finnish children and adolescents aged 1 to 17 years was 1.01 to 1.03 million/year. The incidence was calculated by dividing the number of new users by all age- and sex-matched Finnish inhabitants in the year.ResultsBetween 2008 and 2017, the incidence of antipsychotic use among children and adolescents increased from 2.1 to 3.8 per 1000 individuals, respectively. In children aged 7 to 12 years, the incidence of antipsychotic use 1.4-folded (from 1.9 (95% CI: 1.8–2.0) to 2.7 (95% CI: 2.5–2.9) per 1000) with a cumulative increase of 0.2% per year (χ2 = 51.0, p < 0.0001). In adolescents aged 13 to 17 years, the incidence 2.2-folded (from 4.3 (95% CI: 4.1–4.5) to 9.4 (95% CI: 9.1–9.8) per 1000) with a cumulative increase of 0.6% per year (χ2 = 590.3, p < 0.0001). The increase in the incidence of use was steeper in girls (2.3-fold) than in boys (1.4-fold) (χ2 = 85.6, p < 0.0001), especially between 2015 and 2017 (1.6-fold and 1.2-fold, respectively) (χ2 = 151.7, p < 0.0001). The year 2011 was the turning point when the incidence in girls exceeded the incidence in boys, and the incidence of quetiapine use exceeded that of risperidone use.ConclusionsThe incidence of antipsychotic use increased between 2008 and 2017, especially in adolescent girls. The use of quetiapine increased, although it has few official indications in children and adolescents. Future studies should investigate the reasons for increasing use of antipsychotics, especially quetiapine, in children and adolescents.

引言近期，许多国家儿童及青少年抗精神病药物处方量呈上升趋势。此类药物往往被非标示使用，尽管抗精神病药物与不良反应相关联。本研究旨在评估芬兰儿童及青少年抗精神病药物使用近年的发病率。方法通过检索芬兰国家处方登记系统，收集了2008年1月1日至2017年12月31日期间（n = 26,353）开始使用抗精神病药物的1至17岁儿童及青少年病例。2008年至2017年，芬兰1至17岁儿童及青少年人数约为101万至103万人/年。发病率通过将新用户数量除以当年所有年龄和性别匹配的芬兰居民数来计算。结果2008年至2017年，儿童及青少年抗精神病药物使用发病率从每千人的2.1例上升至3.8例。在7至12岁儿童中，抗精神病药物使用发病率增至1.4倍（从每千人的1.9例（95% CI: 1.8–2.0）上升至2.7例（95% CI: 2.5–2.9）），年累积增长率为0.2%（χ2 = 51.0，p < 0.0001）。在13至17岁青少年中，发病率增至2.2倍（从每千人的4.3例（95% CI: 4.1–4.5）上升至9.4例（95% CI: 9.1–9.8）），年累积增长率为0.6%（χ2 = 590.3，p < 0.0001）。使用发病率在女孩中（增长2.3倍）高于男孩（增长1.4倍）（χ2 = 85.6，p < 0.0001），尤其是在2015年至2017年期间（分别增长1.6倍和1.2倍）（χ2 = 151.7，p < 0.0001）。2011年为转折点，此时女孩的发病率超过男孩，喹硫平的使用发病率超过利培酮。结论2008年至2017年，抗精神病药物使用发病率有所上升，尤其在青少年女孩中。尽管喹硫平在儿童及青少年中的官方适应症较少，但其使用量却有所增加。未来的研究应探讨儿童及青少年抗精神病药物，尤其是喹硫平使用量增加的原因。