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Federal Officials Investigate Antipsychotic Drug Use in Children on Medicaid

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Federal officials are investigating the use of antipsychotic drugs in children enrolled in Medicaid. The Wall Street Journal reports the probe was sparked by concerns the drugs are being prescribed too often to treat behavior problems in very young children.

The Inspector General’s Office in the Department of Health and Human Services (HHS) has started the review, the article notes. It focuses on the five largest Medicaid states: California, Florida, Illinois, New York and Texas. The investigation will cover six months in 2011, when 84,654 children age 17 and younger in those states received prescriptions for antipsychotics paid for by Medicaid.

Agencies within HHS are requiring states to more closely oversee Medicaid prescriptions for children for drugs such as Abilify, which is known as an “atypical” antipsychotic. These drugs were developed to treat mental illnesses such as schizophrenia, but now have Food and Drug Administration approval to treat children with conditions including bipolar disorder and irritability associated with autism.

According to the firm Mathematica Policy Research, which analyses Medicaid data for HHS, the number of people under age 20 receiving Medicaid-funded prescriptions for antipsychotic drugs tripled between 1999 and 2008.

Dr. Stephen Cha, a Chief Medical Officer at the Centers for Medicare & Medicaid Services, says doctors should consider treatments other than antipsychotics, including therapy to help children and families deal with psychological trauma that could be causing behavior issues.

A study published last year in the Archives of General Psychiatry found antipsychotic treatment has increased rapidly among young people in the United States, with much of the increase coming from prescriptions for disruptive behavior disorders such as attention deficit/hyperactivity disorder. The researchers reported that antipsychotic drugs are prescribed during almost one in three visits children and teenagers make to psychiatrists in the United States, an increase from one in 11 in the 1990s.

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