An examination of the rates of antipsychotic medication prescription among foster youth in the United States: A systematic review

Federal and state initiatives to monitor appropriate prescribing of psychotropic medications to youth in the child welfare system have been implemented to varying degrees across the United States, yet antipsychotic prescribing trends remain a concern for foster youth. This systematic review explores the prevalence of antipsychotic use among foster youth in the U.S. by examining peer-reviewed studies (n=7) published between 2012 and 2018. Results demonstrate that antipsychotic use among foster youth generally plateaued around 2008 after a large increase in the early 2000s. Despite the plateau, indications of overuse and off-label prescribing, as well as findings that monitoring services are not being utilized by the majority, leave much room for concern for this vulnerable population. Future research should address ways to educate primary care physicians in the area of pediatric mental health, evaluate more recent Medicaid claims data regarding antipsychotics as they are released, and assess the long-term implications of off-label antipsychotic prescribing.