The number of Australian children on antidepressants, sedatives and other drugs to manage mental disorders has skyrocketed in the last decade, according to a new study which also questions if doctors should be prescribing those pharmaceuticals at such elevated rates.
Monash University researchers found the prevalence of dispensing psychotropics for children and adolescents aged 18 years and younger was twice as high in 2021 than in 2013, and girls aged 13-18 showed the most dramatic increase.
Psychotropic pharmaceuticals are typically prescribed to kids with disorders like schizophrenia, ADHD, autism, depression and anxiety.
Associate professor Luke Grzeskowiak said "one of the key" trends the study exposed was the number of children being prescribed psychotropics for the first time, and the length of time kids were staying on those drugs after beginning treatment.
Staying on psychotropics, which include antipsychotics, antidepressants, psychostimulants, anxiolytics and sedative agents, for too long was potentially unsafe, he said, because often the evidence from safety trials is based on short-use duration.
"Once we start seeing people on (psychotropics) for one - three years, we're well beyond the evidence that we have about what the benefits and potential harms might be in those situations," he said.
"You're subjecting young brains to medicines for long periods of time, and we don't truly know what the long-term implications are of that."
Of all the different kinds of psychotropics, the study found that in 2021 boys were most commonly prescribed psychostimulants, which are generally used to treat ADHD, while girls were being dispensed antidepressants at highest rates.
The overall prevalence of psychotropic dispensing to children and adolescents was 33.8 per 1000 boys and 25.2 per 1000 girls in 2013, and 60.0 per 1000 boys and 48.3 per 1000 girls in 2021.
While the increasing trajectories of psychotropic use was "not entirely unexpected" given the impact of the pandemic and other societal factors, Grzeskowiak said there were "definitely concerning elements" to emerge from the data.
He said the study should prompt further research "to truly assess the appropriateness" of prescribing these drugs and to ensure that medicines "are not being used as alternatives" to psychotherapy or other mental health support services.
According to research, the prevalence of mental health issues in young people is on the rise, as is the prescribing of medicines to support management of those conditions.
Whether the marked increases in psychotropic dispensing during the COVID-19 pandemic was justified, particularly to adolescent girls, needed to be investigated, Grzeskowiak said.
Complicating the overall picture, he said, is Australia's overstretched healthcare system.
Doctors are now so overburdened that their ability to closely monitor youth and their suitability to remain on psychotropic pharmaceuticals is diminished, he feared.
"There's the concern, I guess, that once people are started, there's a reluctance to take these things away, or the health system is so burdened that no one has a chance to sit down and go, 'Is this still needed or still appropriate?'"
In seeking to explain the increased rate of prescription for girls over boys, Grzeskowiak said deeper research was needed, but the corrosive impact of social media and differences in health-seeking behaviours between the sexes were possible factors.
"There's been a lot talked about in terms of the increase in eating disorders, particularly in young girls, which have coincided with the pandemic but also because of social media and what's being shown on social media," he said.
"It may also be that girls are more likely to recognise when mental health issues are present and to seek support for that, compared to the boys.
"Or it could actually represent differential impacts of the pandemic on girls. They may be disproportionately impacted by lockdowns or restrictions."
Because of the significant jump in dispensing in 2021, researchers compared changes in Victoria and New South Wales where lockdowns were more extensive than in other states.
But they found that dispensing in those two states was similar to other parts of Australia, suggesting the impacts of the pandemic have been felt nationwide.
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