Study Reveals Alarming Trends in Antipsychotic Prescribing for Youth

A recent study led by Dr. Yana Vinogradova from the University of Nottingham has uncovered significant issues related to the prescribing of antipsychotic medication among children and young people (CYP) in England. Published in the BMJ Mental Health on July 14, 2025, the research highlights concerning trends in the inappropriate use of antipsychotics and the insufficient monitoring of patients following such prescriptions.

The study, funded by the National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, analyzed encoded general practice data linked to hospital admissions and outpatient data. The research team aimed to evaluate trends in antipsychotic prescriptions, reasons for prescribing, treatment durations, and the levels of health monitoring for CYP aged between 5 and 17 years. The findings revealed that between 2006 and 2021, there was a marked increase in antipsychotic prescriptions for youth, particularly among adolescent females.

Dr. Vinogradova pointed out that just under half of the recorded indications for these prescriptions were related to the mental health conditions explicitly linked to antipsychotic treatment in the National Institute for Health and Care Excellence (NICE) guidelines. Alarmingly, 62% of prescriptions were for autism, and over one-third of patients had mental health symptoms without a recorded diagnosis, indicating a potential misapplication of antipsychotic medications.

The NICE guidelines recommend that only secondary care specialists should prescribe antipsychotics to CYP and manage their initial health monitoring for at least the first year. However, the study found that health monitoring levels were generally low, particularly for those with autism or Tourette's syndrome, compared to those with psychosis or bipolar disorder.

In discussing the implications of the findings, Dr. Vinogradova emphasized the need for more comprehensive data collection and better adherence to established guidelines. She noted that the incompleteness of encoded GP records could lead to a misrepresentation of the treatment landscape for CYP with complex mental health needs. The separation of primary and secondary care records exacerbates this issue, as data must undergo re-encoding, often leading to loss of critical information.

The research team advocates for streamlined, centralized best practice recommendations for antipsychotic treatments that encompass both core and off-label uses. This could improve adherence to treatment protocols and enhance the quality of care provided to CYP.

The study's findings underscore a pressing need for healthcare providers to adhere strictly to established guidelines and to ensure that the prescribing practices for antipsychotics are both appropriate and well-monitored. The implications extend beyond individual patient care, as they highlight systemic issues within healthcare data management and the necessity for policy reforms aimed at safeguarding vulnerable populations.

In conclusion, while the rise in antipsychotic prescribing among youth raises significant concerns, it also presents an opportunity for healthcare systems to reassess their protocols and implement necessary changes to improve patient outcomes and adherence to best practices.