{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T06:44:36Z","timestamp":1783579476496,"version":"3.55.0"},"reference-count":22,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,4,1]]},"abstract":"\n BACKGROUND:<\/jats:title>\n Although the increase in treatment of children and adolescents with antipsychotic medications has been well documented, much less is known about the factors related to the use of these agents and how closely the treatment follows best practice recommendations.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n Prescribers of each antipsychotic medication prescription issued for a Medicaid-insured child in Vermont aged &lt;18 years were sent a prior authorization survey that assessed several domains including the clinical indication, other treatments, metabolic monitoring, prescriber specialty, and prescription origin. These variables were combined to categorize prescriptions as following indications approved by the US Food and Drug Administration (FDA) and best practice guidelines.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n The response rate of the survey was 80%, with 677 surveys from 147 prescribers available for analysis; more than one-half of the respondents were primary care clinicians. Overall, the clinical indication for an antipsychotic prescription followed best practice guidelines 91.7% of the time, with overall best practice guidelines followed at a rate of 50.1%. An FDA indication was followed in 27.2% of cases. Psychiatrists were significantly more likely to follow best practice guidelines than nonpsychiatrists. Antipsychotic medications were typically used only after other pharmacologic and nonpharmacologic treatments were ineffective, although previous treatment with cognitive-behavioral therapy was uncommon (15.5%). Metabolic monitoring that included serial laboratory tests was reported in 57.2% of cases.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Current prescribing patterns of antipsychotic medications for children and adolescents follow best practice guidelines approximately one-half of the time, with nonadherence often related to lack of metabolic monitoring.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.2014-2260","type":"journal-article","created":{"date-parts":[[2015,3,3]],"date-time":"2015-03-03T01:42:13Z","timestamp":1425346933000},"page":"658-665","source":"Crossref","is-referenced-by-count":62,"title":["Antipsychotic Medication Prescribing in Children Enrolled in Medicaid"],"prefix":"10.1542","volume":"135","author":[{"given":"David C.","family":"Rettew","sequence":"first","affiliation":[{"name":"The Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, Vermont;"},{"name":"Vermont Child Health Improvement Program, Department of Pediatrics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne","family":"Greenblatt","sequence":"additional","affiliation":[{"name":"The Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, Vermont;"},{"name":"Vermont Child Health Improvement Program, Department of Pediatrics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jody","family":"Kamon","sequence":"additional","affiliation":[{"name":"Vermont Child Health Improvement Program, Department of Pediatrics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Neal","sequence":"additional","affiliation":[{"name":"Catamaran, Schaumburg, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Harder","sequence":"additional","affiliation":[{"name":"Vermont Child Health Improvement Program, Department of Pediatrics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Wasserman","sequence":"additional","affiliation":[{"name":"Vermont Child Health Improvement Program, Department of Pediatrics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Berry","sequence":"additional","affiliation":[{"name":"Vermont Child Health Improvement Program, Department of Pediatrics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles D.","family":"MacLean","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Vermont College of Medicine, Burlington, Vermont;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Hogue","sequence":"additional","affiliation":[{"name":"Department of Vermont Health Access, Williston, Vermont; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"McMains","sequence":"additional","affiliation":[{"name":"Vermont Department of Mental Health, Williston, Vermont"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2015,4,1]]},"reference":[{"issue":"2","key":"2021120907064457400_B1","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1089\/cap.2007.0006","article-title":"Psychotherapeutic medication prevalence in Medicaid-insured preschoolers.","volume":"17","author":"Zito","year":"2007","journal-title":"J Child Adolesc Psychopharmacol"},{"issue":"6","key":"2021120907064457400_B2","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1097\/01.chi.0000157543.74509.c8","article-title":"Trends in the use of typical and atypical antipsychotics in children and adolescents.","volume":"44","author":"Patel","year":"2005","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"1","key":"2021120907064457400_B3","first-page":"13","article-title":"Trends in antipsychotic drug use by very young, privately insured children.","volume":"49","author":"Olfson","year":"2010","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"6","key":"2021120907064457400_B4","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1001\/archpsyc.63.6.679","article-title":"National trends in the outpatient treatment of children and adolescents with antipsychotic drugs.","volume":"63","author":"Olfson","year":"2006","journal-title":"Arch Gen Psychiatry"},{"key":"2021120907064457400_B5"},{"key":"2021120907064457400_B6"},{"issue":"3","key":"2021120907064457400_B7","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1176\/appi.ps.201200081","article-title":"Antipsychotic use by Medicaid-insured youths: impact of eligibility and psychiatric diagnosis across a decade.","volume":"64","author":"Zito","year":"2013","journal-title":"Psychiatr Serv"},{"key":"2021120907064457400_B8","unstructured":"Institute for Health, Health Care Policy and Aging Research at Rutgers, The State University of New Jersey, Center for Education and Research on Therapeutics (CERTs). Antipsychotic medication use in Medicaid children and adolescents: report and resource guide from a 16-state study. Available at: http:\/\/rci.rutgers.edu\/\u223ccseap\/MMDLNAPKIDS.html"},{"issue":"2","key":"2021120907064457400_B9","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1176\/ps.2010.61.2.123","article-title":"Evidence-based use of second-generation antipsychotics in a state Medicaid pediatric population, 2001-2005.","volume":"61","author":"Pathak","year":"2010","journal-title":"Psychiatr Serv"},{"issue":"3","key":"2021120907064457400_B10","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1089\/cap.2013.0094","article-title":"Atypical antipsychotic use among medicaid-insured children and adolescents: duration, safety, and monitoring implications.","volume":"24","author":"Burcu","year":"2014","journal-title":"J Child Adolesc Psychopharmacol"},{"issue":"12","key":"2021120907064457400_B11","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1001\/archgenpsychiatry.2012.647","article-title":"National trends in the office-based treatment of children, adolescents, and adults with antipsychotics.","volume":"69","author":"Olfson","year":"2012","journal-title":"Arch Gen Psychiatry"},{"issue":"4","key":"2021120907064457400_B12","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1089\/cap.2006.0039","article-title":"Antipsychotic-related abnormal involuntary movements and metabolic and endocrine side effects in children and adolescents.","volume":"17","author":"Laita","year":"2007","journal-title":"J Child Adolesc Psychopharmacol"},{"key":"2021120907064457400_B13"},{"issue":"6","key":"2021120907064457400_B14","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1177\/070674370705200605","article-title":"Survey of atypical antipsychotic prescribing by Canadian child psychiatrists and developmental pediatricians for patients aged under 18 years.","volume":"52","author":"Doey","year":"2007","journal-title":"Can J 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