Use of antipsychotics in children and adolescents in Spain, 2015–2023: A real-world, population-based study

INTRODUCTION: Antipsychotic (AP) prescription has risen across Europe, but updated data on prescribing trends and treatment intensity in youth remain limited. This study describes AP prescription patterns among children and adolescents in the region of Valencia, Spain, with 5 million inhabitants. METHODS: Population-based, cross-sectional study using the Valencia Health System's Integrated Database (VID) including all AP drugs prescribed to individuals aged 0-19 years from 2015 through 2023. APs were categorized by active substance, and yearly trends in prescription volume, patient numbers, and chlorpromazine equivalent doses (CED) per patient were presented. Results were stratified by age and sex. RESULTS: A total of 570,238 AP prescriptions were dispensed to 30,704 patients, increasing 1.61-fold over the study period. Risperidone and aripiprazole accounted for 60.5% of all prescriptions, while lurasidone experienced the highest growth (13-fold increase), followed by olanzapine (3.1-fold), aripiprazole (2.3-fold), and quetiapine (2.1-fold). The number of treated patients increased by 50%, with the highest relative increase in young children (0-4 years old) and adolescents (15-19 years old). AP use was higher in males but rose more sharply among females (1.4-fold vs 2.1-fold). Overall, CED per patient slightly declined. CONCLUSIONS: AP prescriptions and patients treated among Spanish youth increased significantly between 2015 and 2023, with notable differences by age and sex. While total CED rose, treatment intensity per patient remained relatively stable. Future studies should investigate the clinical indications for these prescriptions as well as the outcomes associated with AP use in children and adolescents.