A first-of-its-kind study found that children in foster care were as likely to receive multiple antipsychotic prescriptions as children with severe disabilities who would typically be treated with these potent, but problematic drugs.

The study, published in Pediatrics, raises concerns that doctors are prescribing antipsychotics such as Risperdal and Seroquel to treat behavior problems of foster children just as much as they are prescribing the drugs to treat schizophrenia and bipolar disorder. Antipsychotics can be lifesavers for children with severe mental disorders, but can cause numerous side effects, including delusions and weight gain and other metabolic issues.

“The kids in foster care may come from bad homes, but they do not have the sort of complex medical issues that those in the disabled population do,” said Susan dosReis, an associate professor in the University of Maryland School of Pharmacy and the lead author. Her comments came in a New York Times article on the subject.

As reported by the Star Tribune earlier this year, there has been a dramatic increase in antipsychotic prescriptions to children for bipolar disorder, and also cases in which these questionable prescriptions and diagnoses caused problems. (More stories from this Fragile Minds series will be coming soon.)

The latest study examined 2003 Medicaid prescription records in an unnamed mid-Atlantic state. Records were compared for children in foster care, on state disability programs, and receiving support from the Temporary Assistance for Needy Families (TANF) program.

The authors cautioned there are many reasons why foster children might be as likely to receive multiple antipsychotic prescriptions. One drug might have been for a psychiatric disorder -- perhaps one that wasn't mentioned in the Medicaid records used for the study -- while the other might have been to quell a sleeping problem. But the study also suggests that "a propotion (of the foster children) might lack a reasonable clinical rationale" for the drugs they received.

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