Aifa Report

Psychotropic drugs: prescriptions in paediatric age double

These are mainly antipsychotics, antidepressants and drugs for ADHD: in Italia consumption is lower than in the EU countries but the trend is increasing

by Ernesto Diffidenti

Young woman in a mental therapy session talking with a psychologist in the office. Pormezz - stock.adobe.com

4' min read

Translated by AI
Versione italiana

4' min read

Translated by AI
Versione italiana

Since 2016, both the prevalence of use and consumption of paediatric psychotropic drugs have more than doubled. Although they still remain at low levels, they have risen from 20.6 packs per 1000 children (prevalence of 0.26%) in 2016 to 59.3 packs per 1000 children (prevalence of 0.57%) in 2024. These are mainly antipsychotics, antidepressants and ADHD drugs. These are the data from the OsMed 2024 Report on the use of medicines in Italia, produced by the Italian Medicines Agency (Aifa), according to which, during 2024, approximately 4.6 million children and adolescents received at least one pharmaceutical prescription, equal to 50.9% of the Italian paediatric population, with a slightly higher prevalence in males than females (51.9% versus 49.9%).

Recourse to psychotropic drugs increases with age

"The use of psychotropic drugs," underlines the Aifa report, "shows an upward trend by age, reaching a maximum in the 12-17 age bracket, in which a consumption of 129.1 packages per 1,000 and a prevalence of 1.17% is recorded. An upward trend, therefore, in line with the results of other published international epidemiological studies, which show a general upward trend in prescription rates for these drugs in all countries of the world, especially following the Covid-19 pandemic. In Italia, despite the increase observed in recent years, partly linked to the consequences of the pandemic emergency on the mental health of children and adolescents, the use of psychotropic drugs remains significantly lower than in other countries. In 2024, the prescription of these medicines in the Italian paediatric population will stand at 0.57%, a figure that has indeed doubled since 2020 (0.30%), but is still lower than in other European (e.g. France with 1.61%) and non-European (USA 24.7%-26.3%) countries. The use of psychotropic drugs in the paediatric population in Italy is still lower than in other countries

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Most prescribed paediatric drugs

According to the Osmed report, anti-infectives for systemic use are confirmed as the therapeutic category with the highest consumption in paediatric age, followed by drugs for the respiratory system and systemic hormonal preparations, excluding sex drugs and insulins; for all categories there is an increase in consumption compared to the previous year. Central nervous system medicines (antiepileptics, antipsychotics, antidepressants and psychostimulants) are in fourth place among the most prescribed medicines, with consumption accounting for 8% of the total and an increase of 4.1% over 2023.

The trend in Tuscany and Lazio

The alarm launched by Aifa on the consumption of psychotropic drugs in paediatric age calls for coordinated attention between paediatricians, child neuropsychiatrists, general practitioners and pharmacists, says Andrea Cicconetti, president of Federfarma Roma, emphasising that 'as pharmacists we have noted an increase in demand, both for drugs indicated for attention-deficit and hyperactivity disorders and for anxiolytics and opioids'.

Particularly significant is the increase in ADHD drugs, which in Lazio reach 12.3 packages per 1,000 children, compared to the national average of 4.9, with an annual variation of +30.8%. "Particularly for anxiolytics and opioids," Cicconetti proposes, "it would be crucial to complete the national transition to the white electronic prescription in order to counter any falsifications and improve the traceability of prescriptions. At the same time, it is necessary to invest in health literacy, involving families and young people, to promote a more aware and appropriate use of these drugs'.

Tuscany also has a significantly higher consumption of psychopharmaceuticals than the national average. 'What is worrying,' explains Valentina Albertini, president of the Foundation of the Order of Psychologists of Tuscany, 'is above all the use of psychotropic drugs in minors. Being the first region in Italia for prevalence of psychotropic drug use in under-18s (0.96% against the national average of 0.57%) is not a record to boast about. When the public services for children and adolescents are understaffed and are unable to deliver complex psychotherapeutic and rehabilitative courses in a timely manner, and for various reasons the private route is not recommended, the only way out to manage the emergency and the influx of applications is pharmacological stabilisation'.

The importance of early intervention

Early and appropriate intervention, on the other hand, could significantly change the developmental trajectory of young people with a mental problem. Reinforcing this thesis is a study just published in JAMA Psychiatry, presented at the 5th Sinpia-Sinpf Joint Congress in Cagliari. The study, conducted on a total of 700 thousand young people, followed for over eight years about 4 thousand children and adolescents diagnosed with ADHD, showing that standard pharmacological treatment (with methylphenidate) in children diagnosed before the age of 13 is associated with a reduction in the risk of developing psychosis in adulthood of about 21-24% compared to the untreated. 'As scientific societies,' conclude Elisa Fazzi (Sinpia president) and Matteo Balestrieri (Sinpf co-president), 'we point out the need to overcome some critical issues that make access to care and treatment difficult for families and patients, including the complex prescribing modalities of methylphenidate and the limitation of prescriptions to reference centres only'.

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