Sedative Antipsychotic Use by Children and Adolescents in The Netherlands: Dosages, Duration, and Prescribers

BACKGROUND: Increasing dispensing of sedative antipsychotics in children and adolescents has been reported in several countries, including the Netherlands, raising concerns about appropriate prescribing and safety. While previous studies have described antipsychotic use in Dutch youth, detailed information on dispensing patterns, dosages, treatment duration, and prescribers of sedative antipsychotics remains limited. This study therefore examined the dispensing patterns of quetiapine, olanzapine, and pipamperone and compared them with aripiprazole and risperidone, using data from the IADB.nl database. METHODS: Data from the IADB.nl pharmacy dispensing database (120 Dutch community pharmacies) were analyzed to assess sedative antipsychotic dispensing patterns in children and adolescents, aged between 0 and 19 from 2017 to 2022. Dispensing rates, dosages, durations, sex differences, and prescriber types were analyzed using descriptive statistics, Kaplan-Meier survival analysis, Wilcoxon signed-rank tests, and Kolmogorov-Smirnov tests. RESULTS: Dispensing rates increased for quetiapine (0.33 to 0.63/1000) and olanzapine (0.16 to 0.23/1000) from 2017 to 2022, while pipamperone decreased (0.54 to 0.33/1000). Most quetiapine prescriptions (91.5%) were low-dose (