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Antipsychotic medications are FDA-approved in children and adolescents for treatment of schizophrenia, bipolar disorder, autism (for irritability), and Tourette syndrome. However, the vast majority of prescriptions are for off-label diagnoses (NEJM JW Psychiatry Jul 2006 and Arch Gen Psychiatry 2006; 63:679). To examine the effect of antipsychotic tapering in hospitalized youth, investigators reviewed the charts of 74 consecutively admitted patients (age range, 6–16 years; age <12, 43%; 75% male) hospitalized for severe aggression unresponsive to outpatient interventions.
Most patients (76%) had histories of trauma and averaged three diagnoses, including disruptive disorder (52%), anxiety (23%), and mood disorder (7%). None of the patients h…