By LINDSEY TANNER, AP Medical Writer Mon May 5, 12:15 AM ET

CHICAGO - American children take anti-psychotic medicines at about six
times the rate of children in the United Kingdom, according to a
comparison based on a new U.K. study.

Does it mean U.S. kids are being over-treated? Or that U.K. children
are being under-treated?

Experts say that's almost beside the point, because use is rising on
both sides of the Atlantic. And with scant long-term safety data, it's
likely the drugs are being over-prescribed for both U.S. and U.K.
children, research suggests.

Among the most commonly used drugs were those to treat autism and
hyperactivity.

In the U.K. study, anti-psychotics were prescribed for 595 children at
a rate of less than four per 10,000 children in 1992. By 2005, 2,917
children were prescribed the drugs at a rate of seven per 10,000 — a
near-doubling, said lead author Fariz Rani, a researcher at the
University of London's pharmacy school.

The study is being released Monday in the May edition of the journal
Pediatrics.

By contrast, an earlier U.S. study found that nearly 45 American
children out of 10,000 used the drugs in 2001 versus more than 23 per
10,000 in 1996.

There are big differences that could help explain the vastly higher
U.S. rate.

A recent report in The Lancet suggested that the U.K.'s universal
health care system limits prescribing practices there. The report also
said direct-to-consumer ads are more common in the United States.
These ads raise consumer awareness and demand for medication.

While drug company ties with doctors are common in both the U.S. and
U.K., Vanderbilt University researcher Wayne Ray said U.K. physicians
generally are more conservative about prescribing psychiatric drugs.
Ray co-authored the U.S. study, published in 2004.

The new U.K. study, involving 1992-2005 health records of more than
16,000 children, is the first large examination of these drugs in U.K.
children. It found the increase was mostly in medicines that haven't
been officially approved for kids. They were most commonly prescribed
for behavior and conduct disorders, which include attention deficit
disorder.

Side effects including weight gain, nervous-system problems and heart
trouble have been reported in children using these drugs and there's
little long-term evidence about whether they're safe for them, the
study authors said.

"This highlights the need for long-term safety investigations and
ongoing clinical monitoring," they said, "particularly if the
prescribing rate of these medicines continues to rise."

One of the most commonly used anti-psychotics in the U.K. study was
Risperdal, a schizophrenia drug that is sometimes used to treat
irritability and aggression in autism. Its side effects include
drowsiness and weight gain.

Thioridazine, sometimes used to treat hyperactivity in attention
deficit disorder, was frequently used early on. Its use decreased
after 2000 when a U.K. safety committee warned of heart-related side
effects, the authors said.

Reasons for the increases are uncertain but may be similar to those in
the United States, such as an increase in autism cases and drug
industry influence.

In both countries, the issue isn't simply how many children are
getting these drugs, said Dr. David Fassler, a University of Vermont
psychiatry professor. "The more important question is whether or not
the right kids are getting the most appropriate and effective
treatment possible," he said. Fassler wasn't involved in the study.

Dr. William Cooper, a Vanderbilt pediatrician, said the study shows
the drugs are being used "without full understanding about the risks."

"I find it really interesting that we're now seeing increases in other
countries besides the U.S., which suggests that the magnitude of this
issue is global," said Cooper, also an author of the 2004 U.S. study.

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