(236) Increased Prescribing of Neuroleptics to Children in Sweden

Background: Use of neuroleptics in the Swedish pediatric population has increased in the past decades, despite such use often being off-label.

Objectives: To describe the change in use of neuroleptics in children by sex and type of neuroleptics prescribed between 2007 and 2021.

Methods: A register-based study including dispensing data from the National Prescribed Drug Register in Sweden. All children 5-17 years of age with at least one prescription of neuroleptics (ATC-code N05A) dispensed between 2007 and 2021 were included. The annual prevalence of dispensed neuroleptics per 10,000 children resident in Sweden was calculated.

Results: In total, 55,365 children were dispensed neuroleptics during the study period. The number went from 2,321 (37% girls) in 2007 to 5,942 (48% girls) in 2021, a total increase of 156%. The prevalence increased from 20.1/10,000 in boys and 12.7/10,000 in girls in 2007 to 37.3/10,000 in boys and 36.6/10,000 in girls in 2021. This corresponds to plus 86% in boys and plus 186% in girls.
In 2007, 11,288 prescriptions of neuroleptics were dispensed to children 5-17 years of which 92.4% were classified as Second-Generation Antipsychotics (SGA) and 7.6% First-Generation Antipsychotics (FGA). In 2021, 30,563 prescriptions of neuroleptics were dispensed of which 98.3% SGA and 1.7% FGA.

Conclusions: The pediatric drug utilization of neuroleptics has increased substantially in Sweden. It is noteworthy that the proportion of girls with dispensations has augmented and is now at the same level as for boys. The recommended SGA largely dominated the dispensations.