Correspondence (letter to the editor): More Patients in Less Time

In my opinion, prescriptions of antipsychotic drugs in the child and adolescent psychiatric setting have definitely increased.

In addition to improved diagnostic tools, more attention to prodromal phases of psychological disorders, and improved diagnostic tests, the factor of treatment time and the scarce resource “treatment place” have an (important) role in the increase in prescriptions. The treatment times in hospitals are continually decreasing, the therapeutic teams are forced to treat increasing numbers of patients in the same amount of time and while staff numbers are dropping. Long waiting times for patients and few enticements for the treating staff to accommodate long treatment periods, since these are sanctioned by the healthcare system, make longer treatment periods without medication less attractive. In this setting, using medication rapidly creates a solution, albeit only an apparent one. Since hardly any antipsychotic drugs have been approved for the use in children and adolescents—which creates additional hurdles—it is not surprising (from a cost point of view too) that the main medication prescribed consists of atypical neuroleptic drugs.

In order to counteract the prescription of antipsychotic drugs in children and adolescents, changes are required in the healthcare system. Longer and more effective treatment periods, which are possible if the hospitals and practices are granted the necessary requirements (greater numbers of treatment places and qualified staff, as well as sufficiently long periods of treatment) the numbers of prescriptions would drop. This would be beneficial for the healthcare system when looking at the longer term, rather than merely a government's term in office. In conclusion: antipsychotic drugs should be prescribed by all means, but only on the background of a validated, sufficiently long, and multimodal treatment that is not primarily concerned with aspects of costs in the short term.