CHILDREN under the age of four are being prescribed antipsychotic drugs in a shocking development that a government report has branded “worrying” and “concerning”.

The prescription of some atypical antipsychotics has more than doubled and more than more than 12,600 kids aged under 19 now using the powerful medications.

These drugs have terrible side effects including weight gain, diabetes, metabolic syndrome, increased cholesterol and high blood pressure.

And there is concern they are being diverted for non approved uses.

A report by the federal government’s Drug Utilisation Subcommittee says the growing prescription of these drugs is “concerning given the potential harms associated with the use of antipsychotics even at low doses”.

“Of particular concern is the increasing use in younger patients,” the report says. More than 2,000 patients under the age of nine, and 110 children under age four, have been prescribed antipsychotic drugs approved to treat autism, schizophrenia and acute mania.

This is even though some of the medicines are not approved for use in children this young.

Psychiatrist Dr George Halasz who has been vocal about the high use of ADHD medication says the huge increase in prescription of these medications raises questions about whether “other diagnoses not being considered”.

“If there had been a 138 per cent increase in any other brand of medicine for insulin or asthma we would be questioning what was going on,” he said.

Professor Jon Jureidini, head of psychiatry at the Women’s and Children’s Hospital Adelaide said his guess was the majority of children being prescribed these medications were not being well managed.

Psychiatrist Dr Robert Adler, who was asked by the government to comment on the report, says if these medications are being used in the under fives they should be prescribed by specialists and only for schizophrenia or the management of aggression in children with autism.

“Schizophrenia ... is very, very rare in the under fives and frankly I don’t think in my proactive (of over 40 years) I have ever seen a child under five with schizophrenia,” he said.

He said there was a role for using them for managing aggressive behaviour in children with autism if other approaches failed.

But doctors may be prescribing the medicine for off label conditions such as anxiety.

“In low doses it is effective in treating anxiety. It is not approved for that but many of us do from time to time prescribe it ... and the patients has to pay full private fees for it,” he said.

The government committee looked at pharmaceutical benefits claims data from 1 December 2010 to 31 December 2012 after alarm bells were rung on growing use of the drugs.

The research found the use of quetiapine which is approved for the treatment of acute mania in children older than ten and for schizophrenia in adolescents older than 13 had more than doubled.

Between 2008 and 2011 there was a 138 per cent increase in the number of patients aged under 19 prescribed the medicine.

The use of risperidone, approved to treat behavioural disorders associated with autism and schizophrenia, increased by 46 per cent.

Prescriptions for onlanzapine approved to treat schizophrenia and acute mania increased by 8 per cent.

The report suggests the marked increase in prescriptions could be due to prescription shopping and suggests the medicines may be diverted to the illegal market.

It is also possible many of these medications are prescribed outside the recommended indications, the report warns.

The most likely off label uses are for aggression associated with conditions other than autism, behavioural insomnia and anxiety and stress.

It could be the result of pressure on mental health workers to reduce the lengths of hospital stays, the use of seclusion and a greater number of disturbed children being discharged to residential treatment rather than home, the report says.

This “is particularly concerning since no formal risk-benefit assessment has been conducted” the report says.

It warns the consequences of using these drugs even in low doses for short periods could be dire.

There is a risk of developing a lifetime behaviour of reliance on medicine to manage insomnia and stress.

Further investigations must be undertaken to ensure these medicines are being prescribed safely and check adequate precautions are being taken to minimise heart, weight and neurological risks, the report says.