Prescription Patterns and Trends of Anxiolytics and Hypnotics/Sedatives among Child and Adolescent Patients with Psychiatric Illnesses in a Psychiatric Center of Northern Taiwan

10.4103/tpsy.tpsy_18_21

Shu-Wen Cheng；Hsiao-Ju Sun；Hung-Yu Chan

benzodiazepines ； gender ； psychiatric illnesses ； status of catastrophic illnesses

台灣精神醫學

35卷2期（2021 / 06 / 01）

82 - 89

英文

Background: The prevalence of prescriptions of anxiolytics and hypnotics/sedatives for child and adolescent patients with psychiatric illnesses is increasing over the world. No studies exist to focus on the prescription trends and patterns of anxiolytics and hypnotics/sedatives for child and adolescent patients in psychiatric hospitals of Taiwan. Methods: In this retrospective study for all outpatients who were equal or younger than 18 years of age in a psychiatric service, we collected related study variables from the study psychiatric services from 2006 to 2015. Reviewing the electronic medical information system, we extracted both patients' demographic or clinical data (such as sex, age, as well as psychiatric diagnoses), and prescriptions of anxiolytics and hynotics/sedatives. Results: During the study period, the proportion of patients received anxiolytics and hypnotics/sedatives was decreased significantly (from 9.16% in 2006 to 5.85% in 2015, p ＜ 0.001). The proportion of patients received anxiolytics was significantly decreased (from 5.34% in 2006 to 4.54% in 2015, p ＞ 0.05), while hypnotics/sedatives was also decreased significantly (from 5.35% to 2.27%, p ＜ 0.001). Logistic regression analysis showed that the use of anxiolytics and hypnotics/sedatives was significantly associated with age (p ＜ 0.001), gender (p ＜ 0.001), patients' status of catastrophic illnesses (p ＜ 0.001), and diseases (p ＜ 0.001). Conclusion: Anxiolytics and hypnotics/sedatives have the rôles in the treatment of child and adolescent patients with psychiatric Illnesses. Clinicians should be aware of the adverse events of these medications and prescribe them carefully for this population. Certainly, we need more well-designed clinical studies to study the safety and efficacy of anxiolytics and hypnotics/sedatives medications for children and adolescents.

1. Cheng, SW,Chan, HY(2017).Antipsychotic prescription pattern among child and adolescent patients with psychiatric illnesses in Taiwan.Taiwan J Psychiatry,31,222-231.
   連結：
2. Wang, JP(2013).Excessive use of sedatives/hypnotics/anxiolytics in Taiwan.Taiwan J Psychiatry,27,95-98.
   連結：
3. Acquaviva, E,Legleye, S,Auleley, GR(2009).Psychotropic medication in the French child and adolescent population: prevalence estimation from health insurance data and national self-report survey data.BMC Psychiatry,9,72.
4. Agarwal, SD,Landon, BE(2019).Patterns in outpatient benzodiazepine prescribing in the United States.JAMA Netw Open,2,e187399.
5. Antochi, R,Stavrakaki, C,Emery, PC(2003).Psychopharmacological treatments in persons with dual diagnosis of psychiatric disorders and developmental disabilities.Postgrad Med J,79,139-146.
6. Bénard-Laribière, A,Pariente, A(2018).Benzodiazepine use and misuse in France.Presse Med,47,878-881.
7. Birmaher, B,Brent, DA,Benson, RS(1998).Summary of the practice parameters for the assessment and treatment of children and adolescents with depressive disorders.J Am Acad Child Adolesc Psychiatry,37,1234-1238.
8. Cates, ME,Bishop, MH,Davis, LL(2004).Clonazepam for treatment of sleep disturbances associated with combat-related posttraumatic stress disorder.Ann Pharmacother,38,1395-1399.
9. Chirdkiatgumchai, V,Xiao, H,Fredstrom, BK(2013).National trends in psychotropic medication use in young children: 1994-2009.Pediatrics,132,615-623.
10. Dold, M,Li, C,Tardy, M(2012).Benzodiazepines for schizophrenia.Cochrane Database Syst Re,11,Cd006391.
11. Hartz, I,Skurtveit, S,Steffenak, AK(2016).Psychotropic drug use among 0-17 year olds during 2004-2014: a nationwide prescription database study.BMC Psychiatry,16,12.
12. Hsia, Y,Maclennan, K(2009).Rise in psychotropic drug prescribing in children and adolescents during 1992-2001: a population-based study in the UK.Eur J Epidemiol,24,211-216.
13. Huerta, C,Abbing-Karahagopian, V,Requena, G(2016).Exposure to benzodiazepines (anxiolytics, hypnotics and related drugs) in seven European electronic healthcare databases: a cross-national descriptive study from the PROTECT-EU Project.Pharmacoepidemiol Drug Saf,25,56-65.
14. Hugtenburg, JG,Heerdink, ER,Egberts, AC(2004).Increased psychotropic drug consumption by children in the Netherlands during 1995-2001 is caused by increased use of methylphenidate by boys.Eur J Clin Pharmacol,60,377-379.
15. Ipser, JC,Stein, DJ,Hawkridge, S(2009).Pharmacotherapy for anxiety disorders in children and adolescents.Cochrane Database Syst Rev,3,Cd005170.
16. John, A,Marchant, AL,McGregor, JI(2015).Recent trends in the incidence of anxiety and prescription of anxiolytics and hypnotics in children and young people: an e-cohort study.J Affect Disord,183,134-141.
17. Koelch, M,Prestel, A,Singer, H(2009).Psychotropic medication in children and adolescents in Germany: prevalence, indications, and psychopathological patterns.J Child Adolesc Psychopharmacol,19,765-770.
18. Lopez-Leon, S,Lopez-Gomez, MI,Warner, B(2018).Psychotropic medication in children and adolescents in the United States in the year 2004 vs 2014.Daru,26,5-10.
19. Morishita, S(2009).Clonazepam as a therapeutic adjunct to improve the management of depression: a brief review.Hum Psychopharmacol,24,191-198.
20. Nardi, AE,Perna, G(2006).Clonazepam in the treatment of psychiatric disorders: an update.Int Clin Psychopharmacol,21,131-142.
21. O’Sullivan, K,Reulbach, U,Boland, F(2015).Benzodiazepine prescribing in children under 15 years of age receiving free medical care on the General Medical Services scheme in Ireland.BMJ Open,5,e007070.
22. Olfson, M,Druss, BG,Marcus, SC(2015).Trends in mental health care among children and adolescents.N Engl J Med,372,2029-2038.
23. Olfson, M,Marcus, SC,Weissman, MM(2002).National trends in the use of psychotropic medications by children.J Am Acad Child Adolesc Psychiatry,41,514-521.
24. Oray, NC,Hocaoglu, N,Oray, D(2008).Sedative-hypnotic medication exposures and poisonings in Izmir,Turkey.Basic Clin Pharmacol Toxicol,103,380-385.
25. Patel, DR,Feucht, C,Brown, K(2018).Pharmacological treatment of anxiety disorders in children and adolescents: a review for practitioners.Transl Pediatr,7,23-35.
26. Ricketts, RW,Goza, AB,Ellis, CR(1994).Clinical effects of buspirone on intractable self-injury in adults with mental retardation.J Am Acad Child Adolesc Psychiatry,33,270-276.
27. Schirm, E,Tobi, H,Zito, JM(2001).Psychotropic medication in children: a study from the Netherlands.Pediatrics,108,E25.
28. Sidorchuk, A,Isomura, K,Molero, Y(2018).Benzodiazepine prescribing for children, adolescents, and young adults from 2006 through 2013: a total population register-linkage study.PLoS Med,15,e1002635.
29. Singh, MK,Ketter, TA,Chang, KD(2010).Atypical antipsychotics for acute manic and mixed episodes in children and adolescents with bipolar disorder: efficacy and tolerability.Drugs,70,433-442.
30. Steffenak, AK,Wilde-Larsson, B,Nordström, G(2012).Increase in psychotropic drug use between 2006 and 2010 among adolescents in Norway: a nationwide prescription database study.Clin Epidemiol,4,225-231.
31. Steinhausen, HC(2015).Recent international trends in psychotropic medication prescriptions for children and adolescents.Eur Child Adolesc Psychiatry,24,635-640.
32. Steinhausen, HC,Bisgaard, C(2014).Nationwide time trends in dispensed prescriptions of psychotropic medication for children and adolescents in Denmark.Acta Psychiatr Scand,129,221-231.
33. Strawn, JR,Geracioti, L,Rajdev, N(2018).Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review.Expert Opin Pharmacother,19,1057-1070.
34. Trenkwalder, C,Hening, WA,Montagna, P(2008).Treatment of restless legs syndrome: an evidence-based review and implications for clinical practice.Mov Disord,23,2267-2302.
35. Tsai, CY,Yang, HC,Islam, M(2017).Psychotropic medications prescribing trends in adolescents: a nationwide population-based study in Taiwan.Int J Qual Health Care,29,861-866.
36. Vitiello, B,Correll, C,van, Zwieten-Boot, B(2009).Antipsychotics in children and adolescents: increasing use, evidence for efficacy and safety concerns.Eur Neuropsychopharmacol,19,629-635.
37. Wang, LJ,Chen, YC,Chen, CK(2014).Trends in anxiolytic-hypnotic use and polypharmacy in Taiwan, 2002-2009: a nationwide, population-based survey.Psychiatr Serv,65,208-214.
38. Witek, MW,Rojas, V,Alonso, C(2005).Review of benzodiazepine use in children and adolescents.Psychiatr Q,76,283-296.
39. Zoëga, H,Baldursson, G,Hrafnkelsson, B(2009).Psychotropic drug use among Icelandic children: a nationwide population-based study.J Child Adolesc Psychopharmacol,19,757-764.