Antipsychotic drug prescriptions high for Oklahoma foster children

Antipsychotic drugs are often prescribed to address disruptive behaviors in children.

Nationally, children in child welfare systems have been prescribed such drugs at two to three times the rate of other children in the community, the study says.

Excessive prescribing of antipsychotic drugs to foster children is a matter of national concern, because the drugs have significant side effects, said Dr. David Rubin, one of the study's authors.

“The biggest issue with antipsychotics has been significant metabolic side effects — significant weight gain within a couple of months on kids who started on those medications,” he said. “It looks like some of those metabolic side effects are worse in children than they are in adults. Now there are concerns about developing some of the complications of obesity in terms of diabetes and hypertension and some of those types of complications.”

The drugs “really dull them,” he said. “We don't have good data on the impact on learning.”

Data shows 14.8 percent of Oklahoma foster children were on antipsychotic prescription drugs in 2007, a rate significantly higher than the national average of 11.8 percent.

The study also revealed 6.2 percent of Oklahoma foster children were on three or more psychotropic medications at once in 2007, a rate higher than the national average of 5.3 percent.

Rubin said 2007 information was the most recent contained in the study because of the slowness with which some states have reported and the federal government has assembled data. Researchers hope to update the report with 2008 and 2009 data soon, he said.

Rubin cautioned against drawing too many conclusions from state-to-state comparisons.

If one state has a higher prescription rate than another, it might be because drugs are being overprescribed in the higher state in situations where many children would be better served by counseling therapy, he said.

On the other hand, the rate in the other state might just be low because officials aren't getting children mental health treatment when they should, he said.

“I think the high rates that we're seeing is really a symptom or the fact we're not providing some of the other therapies, like evidence-based counseling therapies that are really rooted around trauma treatment,” he said. “At the end of the day, we label these kids with a lot of diagnoses, but what they share in common is a significant trauma history and significant relational failures ... The best treatments we have for those are harder to fund in public systems.”