Psychiatria Fennica (Nov 2019)
QUETIAPINE USE BEFORE EIGHTEEN YEARS OF AGE AMONG FORMER ADOLESCENT PSYCHIATRIC INPATIENTS IN NORTHERN FINLAND
Abstract
The use of antipsychotics among children and adolescents has increased in Finland, as it has worldwide. Quetiapine is the second most common antipsychotic prescribed to children and adolescents in Finland, after risperidone. Unlike risperidone, quetiapine has no licensed indication for use in children or adolescents. We examined indications for the prescription of quetiapine to adolescent psychiatric inpatients aged under 18 years. The data covers a clinical sample of 508 adolescents, who were admitted for psychiatric inpatient treatment, between the ages 13–17 years, from April 2001 to March 2006. The psychiatric diagnoses leading to quetiapine prescription were searched from national healthcare registers, provided by the Finnish National Institute for Health and Welfare. The information on purchases of quetiapine, and other psychotropic medications, was obtained from the national register of prescribed medicines, provided by the Social Insurance Institution of Finland. Of the 49 adolescents who had purchased quetiapine before 18 years of age, a total of 32 (65.3%) had an indication for psychotic disorder and 5 (10.2%) for an affective disorder. A total of 12 (24.5%) were defined as being off-label users of quetiapine. Two-thirds of adolescents defined as off-label users of quetiapine had been diagnosed with conduct disorder during index hospitalization. In addition, they were often impulsive, had suicidal behaviour or behavioural instability. The prescription trends of quetiapine in youngsters mainly followed the official indications for quetiapine in adults. This symptomatic use of quetiapine is explained by a belief that it is both less addictive than benzodiazepines and has a lowering impact on suicidal behaviour.
