More Japanese children being prescribed psychotropic drugs
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More Japanese children being prescribed psychotropic drugs

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Staff Writer

A growing number of Japanese children are being prescribed psychotropic drugs to treat depression, attention deficit hyperactivity disorders (ADHD) and schizophrenia, according to a study by government-funded medical institutes.

In particular, the number of ADHD drug prescriptions for patients aged between 13 and 18 years old surged 2.49 times between two three-year periods covering 2002-2004 and 2008-2010, despite some of them being unapproved for use among children, the study said.

“Frankly, this is an unfortunate situation for the medical community” because doctors are having to take legal risks to provide some psychotropic drugs to underage patients, said Yasuyuki Okumura, a researcher at the Institute for Health Economics and Policy and co-author of the research paper.

The paper, which examined a total of 233,399 prescriptions issued by hospitals and clinics from 2002 tol 2010, was published in November in the Japanese medical journal Seishin Shinkeigaku Zasshi (Journal for the Japanese Society of Psychiatry and Neurology).

Doctors in Japan dealing with children suffering psychiatric problems have long prescribed psychotropic drugs approved only for adults, though doing so involves risks for both patient and doctor.

Because their effectiveness and safety are not officially confirmed by the government, doctors run the risk of being sued if serious adverse effects occur.

Okumura said that in Japan few clinical studies exist on psychotropic drugs for children, unlike in the U.S. and Europe, where clinical trials covering children are legally stipulated.

Okumura and his team also found that the number of ADHD drug prescriptions for 6- to 12-year-old children during the years 2008-2010 increased 84 percent compared to the figure during 2002-2004. Also for the same age group, the number of prescriptions for antipsychotic drugs increased 58 percent.

In addition, the research also found that the number of prescriptions for anti-depression drugs for children between 13 and 18 jumped 31 percent.

Okumura said that the increased use of psychotropic drugs for children can probably be attributed to growth in the number of underage patients seeking treatment for psychiatric problems, an increase in the number of doctors and facilities available to provide medical care for such children, and more drugs being approved by the government for use among children.

Health ministry surveys show that the number of children seeking medical care for mental health issues grew from 95,000 in 2002 to 148,000 in 2008.

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  • DiggleDiggle

    Let’s see: there were 233,399 prescriptions issued over eight years, which is roughly 29,175/year. Population of Japan is roughly 127.3 million. So that suggests there are roughly 22 prescription per 1,000 people (0.023%). World-wide prevalence of ADHD is estimated to be between 5.29% and 7.1% (see 1,2). That would suggest that patients are actually being vastly under-treated, no?

    “Okumura said that in Japan few clinical studies exist on psychotropic drugs for children, unlike in the U.S. and Europe, where clinical trials covering children are legally stipulated.”

    Given that the pharmaceutical industry is pretty much internationalized these days, I do not get why the clinical trials, performed in the US and EU, are assumed to be non-applicable to the Japanese population. Japanese differ only in very minor ways physiologically (and, in most cases, not at all), and there is no reason to suspect, a priori, that Japanese race modifies this particular disease’s status. Seems silly to withhold a drug until a very length, expensive clinical trial is repeated on a Japanese cohort. Makes more sense to go ahead approve said drug, establish a sentinel system, and monitor patients as part of, say, a “Phase IV” trial.

    1. Polanczyk G, de Lima MS, Horta BL, et al. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry 2007; 164: 942-948.

    2. Willcutt EG. The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review. Neurotherapeutics. 2012; 9(3):490-9.

  • PeninsulaInfoWar

    Japan rise Autism children.