Health: 'Off-Label' Antipsychotics--for Kids

The statistics are staggering: a sixfold spike, between 1993 and 2002, in the number of doctor visits in which kids and adolescents were prescribed antipsychotic drugs. Total tally in '02: 1.2 million. Antipsychotics are powerful drugs, typically used to treat severe mental illnesses like schizophrenia in adults--and they're not FDA-approved for children. But increasingly, doctors are prescribing newer generations of antipsychotics "off label" for a range of conditions in young people, from mood disorders to behavioral problems and ADHD. The drugs can be helpful for the right patients. In bipolar disorder, anti-psychotics help tame hard-core aggression, which is a devastating characteristic of the disease in young people, says Dr. Joseph Biederman, chief of pediatric psycho-pharmacology at Massachusetts General Hospital: "They've revolutionized the way we can treat these children." But drug trials in kids are limited and short-term, says Columbia University's Dr. Mark Olfson, who led last week's study. And while newer antipsychotics are safer than older ones, they still have side effects, including weight gain, which could increase the risk of diabetes. More studies are urgently needed, says Olfson. "We're in a situation in which practice has gotten ahead of the science," he says. "We've got a lot of work to do to catch up."