The COVID-19 pandemic's impact on psychotropic medication prescriptions for children and adolescents: a scoping review of quantitative longitudinal studies.

Abstract

Global evidence shows a deterioration in the mental health of children and adolescents during the COVID-19 pandemic, raising questions about how mental health care, including psychotropic medication prescriptions, has adapted. However, it remains unclear how this deterioration affected prescription trends. This scoping review examined quantitative longitudinal studies comparing psychotropic drug prescriptions before and during the pandemic. A search of five databases, PubMed, CINAHL, Web of Science, Scopus, and PsycINFO, yielded 14 studies from 11 OECD countries (Austria, Australia, Canada, Denmark, Israel, Italy, the United States, Portugal, Sweden, Norway, and New Zealand). Included studies were quantitative, longitudinal, in English, and focused on individuals aged 0-19. Most used national health registers or clinical data covering pre-pandemic (2013-2019) and pandemic years (2020-2022). Six studies focused exclusively on adolescents (10-19 or 12-18 years), while others included larger age ranges (0-17/18/19 years). Ten studies reported increases in antidepressant and antipsychotic prescriptions during the pandemic, with two showing initial declines followed by rises; four reported overall decreases. Notable gender and age differences emerged, with girls showing the largest rise in antidepressant use and adolescents exhibiting higher usage than younger children. Stimulant prescription trends varied across countries. Socioeconomic disparities and national policy responses, including school closures and healthcare access, also influenced prescribing patterns. Two studies found higher prescription rates among children from more advantaged backgrounds. Twelve studies focused on the early pandemic period, limiting time generalisability, while only two extended into 2022. This review highlights the need for enhanced monitoring and extended longitudinal research to assess the long-term impact of crises like COVID-19 on youth mental health care. It also emphasises the importance of health system preparedness for managing psychiatric treatment in future public health emergencies. Although an overall shift in psychotropic prescribing among children and adolescents is suggested, the limited number of studies and short follow-up periods restrict conclusions about long-term trends.