Medication Use Patterns in Down Syndrome Change as Children Age, Develop

Published October 2015
Journal of Developmental and Behavioral Pediatrics

Specialists who treat children and teens with Down syndrome sometimes encounter “diagnostic overshadowing,” a tendency to attribute a child’s behavior problems to the syndrome, rather than other common conditions.

Now a study that followed hundreds of children with Down syndrome has found that medication use over time follows the same patterns and levels of severity of common neurobehavioral problems reported across the age span.

The study reviewed electronic medical records of 832 patients covering 5,324 visits. Researchers tracked the use of central nervous system (CNS) stimulants, selective serotonin re-uptake inhibitors (SSRI), atypical antipsychotics (AAP), and alpha adrenergic agonists (AAG).

In general, children ages 12-21 were 25 percent more likely to be taking at least one medication compared to children ages 5-11 (17 percent). With each year of age, children aged 5-11 years showed rising odds of receiving stimulants. Typically, the drugs were used to treat attention and hyperactivity problems.

In children 12 and older, stimulant use decreased. However, prescription rates for SSRI and AAP medications were much higher than the younger group. Typically, doctors prescribed these medications to treat anxiety, depression, and other severe behavior problems.

“The pattern of medicine use seemed consistent with the types of problems we see clinically,” says Julia Anixt, MD, co-author of the study. “Behavior issues can become more complicated as children with Down syndrome age, and families may be more comfortable using medication to treat behavior problems in adolescents than in younger children."

Fig A: This figure shows the rates of medication use among children with Down syndrome, by age and category of medication.
Click image to view caption.

Citation

Downes A, Anixt JS, Esbensen AJ, Wiley S, Meinzen-Derr J. Psychotropic Medication Use in Children and Adolescents With Down Syndrome. J Dev Behav Pediatr. 2015 Oct;36(8):613-9.