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.

近期，全球多个国家儿童和青少年抗精神病药物的处方率有所上升。此类药物往往被非标示用途开具，尽管抗精神病药物与不良反应相关联。本研究旨在确定芬兰儿童和青少年近期抗精神病药物的使用发生率。方法：检索了包含所有芬兰居民药物报销信息的芬兰国家处方登记册，以寻找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岁儿童和青少年作为研究对象。在2008年至2017年期间，芬兰1至17岁的儿童和青少年人数范围为每年101万至103万人。发生率通过将新用户数量除以当年年龄和性别匹配的芬兰居民总数计算得出。结果：在2008年至2017年期间，儿童和青少年抗精神病药物的使用发生率从每千人2.1例增加至3.8例。在7至12岁的儿童中，抗精神病药物的使用发生率增加了1.4倍（从每千人1.9例（95% CI: 1.8–2.0）增至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岁的青少年中，发生率增加了2.2倍（从每千人4.3例（95% CI: 4.1–4.5）增至9.4例（95% CI: 9.1–9.8），年累积增长率为0.6%（χ2 = 590.3，p < 0.0001）。使用发生率增加的趋势在女孩中（增加了2.3倍）比男孩中（增加了1.4倍）更为显著（χ2 = 85.6，p < 0.0001），特别是在2015年至2017年之间（分别为增加了1.6倍和1.2倍）（χ2 = 151.7，p < 0.0001）。2011年是转折点，当年女孩的使用发生率超过了男孩，喹硫平的使用发生率超过了利培酮。结论：在2008年至2017年期间，抗精神病药物的使用发生率有所增加，尤其是在青少年女孩中。尽管喹硫平在儿童和青少年中的官方适应症较少，但其使用率却有所上升。未来的研究应探究儿童和青少年抗精神病药物，尤其是喹硫平使用率增加的原因。