Terese Matthesen Kamronn1,2, Christina Gade3*, Sandra Nielsen3, Hanne Rolighed Christensen3, Kim Peder Dalhoff3, Jens Christian Holm4,5,6 and Helle Holst3,7
1Department of Clinical Pharmacology, Aarhus University Hospital, Denmark
2Department of Clinical Pharmacology, Aalborg University Hospital, Denmark
3Department of Clinical Pharmacology, University Hospital Copenhagen, Bispebjerg and Frederiksberg, Denmark
4Children’s Obesity Clinic, Department of Paediatrics, University Hospital Copenhagen, Holbaek, Denmark
5The Novo Nordisk Foundation Center for Basic Metabolic Research, Copenhagen University, Denmark
6Faculty of Health, Copenhagen University, Denmark
7Lundbeck A/S Department of Clinical Pharmacology, H. Lundbeck A/S, Denmark
*Corresponding Author: Christina Gade, Department of Clinical Pharmacology, University Hospital Copenhagen, Bispebjerg and Frederiksberg, Denmark.
Received: September 01, 2020; Published: September 28, 2020
Background: Children with obesity are more prone to suffer from psychiatric disorders. However, drug dosing in complex, as most psychotropic agents even in low dosage associated with drug-induced weight gain.
Objectives: To describe the extent of off-label use, polypharmacy and potential adverse drug event (ADE) related to psychotropic drugs in children and adolescence with obesity.
Methods: A retrospective cohort study including 1.593 patient records of children admitted to a Children´s Obesity Clinic, receiving at least one psychotropic drug during an eight-year study period. Off label status and potential ADEs were registered by assessing patient records and medical charts.
Results: One hundred-fifty-eight children received at least one psychotropic drug during the study period and 52% received more than one psychotropic drug concurrently. Both antidepressants and antipsychotics were prescribed significantly more to girls > 12 years than boys (p = 0.02). In total, 61% of the children had at least 1 ADE registered, with significantly increased ADEs when treated with more than one psychotropic drug (p < 0.001). Abnormal weight gain was the most frequently ADE in antipsychotics, affecting 35% of the treated patients. Ninety-one percent had at least one off-label prescription, e.g. non-approved indication (31.5%), age (1.9%), dose (23.8%), and duration of treatment (0.6%).
Conclusion: Off-label use and polypharmacy is frequent among children with obesity treated for psychiatric disorders. It is problematic, since most antipsychotic and antidepressant drugs have metabolic adverse effects. These findings highlight the importance of including this patient population in clinical trials to determine appropriate efficacy-safety relationships.
Keywords: Off-label; Adverse Drug Events; Polypharmacy; Obesity; Children and Adolescents
Citation: Christina Gade., et al. “Off-label Prescription, Adverse Drug Events and Dosage of Psychotropic Drugs in Children and Adolescents with Obesity - A Retrospective Cohort Study". Acta Scientific Pharmaceutical Sciences 4.10 (2020): 152-164.
Copyright: © 2020 Christina Gade., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.