In just 7 years, the consumption of psychotropic drugs has almost doubled among French children and adolescents. This alarming figure is recorded in the report “When children are in bad shape: how to help them? “, published in early March 2023 by the HCFEA (High Council for the Family, Childhood and Age). Decryption.
Child and adolescent mental health and psychotropic drug use
The Haut Conseil de la Famille, de l’Enfance et de l’Age (HCFEA) compiled health data between 2014 and 2021 to assess the mental health of French children and adolescents. The data analyzed reveals that the consumption of psychotropic drugs has almost doubled over the period considered, with significant variations depending on the drug class:
- An increase of 62.6% for antidepressant drugs;
- An increase of 78.1% for psychostimulant drugs;
- An increase of 27.7% for anticholinergic drugs (which include drugs once morest allergies, nausea but also antidepressant drugs);
- A 9.5% increase for dopaminergic drugs (used in the context of Parkinson’s disease (link to sheet: https://www.sante-sur-le-net.com/ Maladies/neurologie/ Maladie-Parkinson/ ));
- An increase of 155.5% for hypnotic and sedative drugs.
For the year 2021 alone, the increase in the consumption of psychotropic drugs in children was 7.5% for antipsychotics, 16% for anxiolytics, 23% for antidepressants and up to 224% for hypnotics. Worrying figures, which concern tens of thousands of children nationwidewith, for example, no less than 34,791 dispensations just for antipsychotic drugs!
Prescriptions of psychotropic drugs far removed from mental health recommendations
How to explain such a phenomenon ? France has been and has remained for several years the country that consumes the most psychotropic drugs in the world. But the increases observed in children and adolescents are very much higher than the trends of the general population. These data confirm that children and adolescents are more exposed than adults to psychological suffering and mental health disorders, but also more exposed to medication. While in many countries of the world, the trend is to reduce the prescriptions of pharmacological treatments in children, in France, it is increasing.
At the same time, specialized consultations and non-pharmacological therapies intended for children and adolescents are stagnating or even declining. However, the recommendations of the High Authority for Health (HAS) are clear. In first intention, the mental disorders of the child must be supported by non-drug therapies : psychotherapeutic practices; educational practices and prevention and social intervention practices. Drug treatments can only be used as a second-line treatment, and always in combination with first-line treatments.
More means of child psychiatry to reduce the use of psychotropic drugs
The example of psychostimulant drugs highlights the deviations that have become almost systematic in relation to recommendations and marketing authorizations (MA) for drugs. The data reveal, for example, prescriptions before the recommended age of 6 years, long treatment durations for drugs indicated for short durations, prescriptions outside the diagnosis or for diagnoses different from the therapeutic indications of the drugs. Certain drugs, such as antiparkinsonians, are prescribed for children, even though these drugs are not intended for the pediatric population.
Some children appear to be more exposed than others to these drugs, in particular the youngest children in their class, very young children, and children from underprivileged backgrounds. THE difficulties in accessing specialized care, insufficient specialists in children’s mental health, the lack of information for families but also of training for professionals in the education and medico-social sectors are all potential explanations for this alarming situation. The HCFEA rightly recommends an increase in resources dedicated to child psychiatry and the medico-social sector to promote non-drug approaches and reduce the prescriptions of psychotropic drugs in children.
Estelle B., Doctor of Pharmacy
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