Use of Multiple Concurrent Antipsychotics in Children and Adolescents (APC)

Assesses the percentage of children and adolescents who were on two or more concurrent antipsychotic medications for an extended period during the year.

Why It Matters

Antipsychotic prescribing in children and adolescents has increased rapidly in recent decades.1,2 Among those prescribed an antipsychotic, about 1 in 10 are prescribed more than one antipsychotic at the same time.3 Children and adolescents prescribed antipsychotics are at risk for serious health concerns. This includes weight gain, extrapyramidal side effects, hyperprolactinemia and some metabolic effects.4

Risks of multiple concurrent antipsychotic use in children and adolescents has not been systematically investigated. Because of this, guidelines caution against their use. There is a lack of evidence supporting their use and the risks of these medications pose can be high.5 This measure can highlight potentially unsafe use of antipsychotic medications.



*Lower rates signify better performance.


  1. Patten, S.B., W. Waheed, L. Bresee. 2012. “A review of pharmacoepidemiologic studies of antipsychotic use in children and adolescents.” Canadian Journal of Psychiatry 57:717–21.
  2. Cooper, W.O., P.G. Arbogast, H. Ding, G.B. Hickson, D.C. Fuchs, and W.A. Ray. 2006. “Trends in prescribing of antipsychotic medications for US children.” Ambulatory Pediatrics 6(2):79–83.
  3. Toteja, N., J.A. Gallego, E. Saito, T. Gerhard, A. Winterstein, M. Olfson, C.U. Correll. 2013. “Prevalence and correlates of antipsychotic polypharmacy in children and adolescents receiving antipsychotic treatment.” International Journal of Neuropsychopharmacology17(7):1095–105.
  4. Correll, C.U., C.J. Kratochvil, J.S. March. 2011. “Developments in pediatric psychopharmacology: Focus on stimulants, antidepressants, and antipsychotics.” Journal of Clinical Psychiatry 72:655–70.
  5. American Academy of Child and Adolescent Psychiatry. September 2009. “Practice parameter on the use of psychotropic medication in children and adolescents.” Journal of the American Academy of Child and Adolescent Psychiatry 48(9):961–73.

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