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Trends in psychopharmacologic treatment of tic disorders in children and adolescents in Germany

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Abstract

Data on medical treatment of children and adolescents with tic disorders are scarce. This study examined the administrative prevalence of psychopharmacological prescriptions in this patient group in Germany. Data of the largest German health insurance fund were analysed. In outpatients aged 0–19 years with diagnosed tic disorder, psychotropic prescriptions were evaluated for the years 2006 and 2011. In 2011, the percentage of psychotropic prescriptions was slightly higher than in 2006 (21.2 vs. 18.6 %). The highest prescription prevalence was found in Tourette syndrome (51.5 and 53.0 %, respectively). ADHD drugs were most frequently prescribed, followed by antipsychotics. In 2011, prescriptions of second generation antipsychotics (SGA) were higher and prescriptions of first generation antipsychotics (FGA) lower than in 2006. Concerning prescribed antipsychotic substances, in 2011 risperidone prescriptions were higher and tiapride prescriptions lower. Paediatricians issued 37.4 %, and child and adolescent psychiatrists issued 37.1 % of psychotropic prescriptions. The FGA/SGA ratio was highest in GPs (1.25) and lowest in child and adolescent psychiatrists (0.96). From 2006 to 2011, there was only a slight increase in psychotropic prescriptions for children and adolescents with a diagnosis of tic disorder in Germany, which stands in contrast towards the significant increase in psychotropic prescriptions in other child and adolescent psychiatric disorders (e.g. ADHD). There were marked differences in treatment patterns by tic disorder subgroups, with Tourette syndrome patients receiving most frequently psychopharmacotherapy. Risperidone prescriptions increased, probably reflecting a switch in prescribing practice towards up-to-date treatment guidelines. In primary care physicians, dissemination of current tic disorder treatment guidelines might constitute an important educational goal.

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Acknowledgments

The data presented in this manuscript was partially obtained during a study funded by the BARMER GEK. The funders have no involvement with the research. The authors and the research are completely independent of the funders. The corresponding author had full access to all data in the study and had final responsibility for submitting the article for publication.

Conflict of interest

CB has received speaker honoraria from Actelion, Medice, Ferring and Novartis, and author honoraria from BARMER GEK health insurance fund. He has worked as an investigator in clinical trials sponsored by Novartis and Shire. VR has acted as a consultant or member of advisory board for Lilly, Novartis and Shire. He has received honoraria for lectures from Lilly, Medice, Novartis and Shire, and has worked as an investigator in clinical trials sponsored by Novartis, Otsuka and Shire. GG is on the advisory board of the DAK health insurance fund. He has received honoraria from the BKK, BARMER GEK, DAK and TK health insurance funds. FH has received speaker and author honoraria from Apothekerkammer Westfalen-Lippe and BARMER GEK.

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Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, Faculty of Medicine, Philipps-University Marburg, Schützenstr. 49, 35039, Marburg, Germany

    Christian J. Bachmann

  2. Department of Child and Adolescent Psychiatry, Technical University Dresden, Schubertstr. 42, 01307, Dresden, Germany

    Veit Roessner

  3. Division of Health Economics, Health Policy and Health Services Research, Centre for Social Policy Research, University of Bremen, Mary-Somerville-Str. 5, 28359, Bremen, Germany

    Gerd Glaeske & Falk Hoffmann

Authors
  1. Christian J. Bachmann
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  2. Veit Roessner
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  3. Gerd Glaeske
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  4. Falk Hoffmann
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Corresponding author

Correspondence to Christian J. Bachmann.

Additional information

Christian J. Bachmann and Veit Roessner have contributed equally to this work.

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Bachmann, C.J., Roessner, V., Glaeske, G. et al. Trends in psychopharmacologic treatment of tic disorders in children and adolescents in Germany. Eur Child Adolesc Psychiatry 24, 199–207 (2015). https://doi.org/10.1007/s00787-014-0563-6

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  • DOI: https://doi.org/10.1007/s00787-014-0563-6

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