There is widespread concern over the perceived indiscriminant prescribing of antipsychotic medications in children, particularly for those residing in low-income households or foster care. Ongoing safety and efficacy monitoring is suggested by many professional associations.

Describe reported diagnosis and symptomology for over 15,000 children prescribed antipsychotics in the 17- month period from April 2011 through August 2012.

Increase appropriate monitoring of children who are prescribed antipsychotics.

A policy was developed by the North Carolina Division of Medical Assistance, in collaboration with Community Care of North Carolina, that requires prescribers to register patients via a web portal before reimbursement is allowed to the pharmacy. Required registration elements include a patient's primary diagnosis, target symptom for medication use, initiating prescriber, caregiver support of medication use, adverse drug event reporting, and metabolic monitoring deemed best practice by the literature review.

From April of 2011 through August 2012, a total of 1,241 prescribers have written 29,691 prescriptions for 15,194 patients in the A+KIDS program. Unspecified Mood Disorder was the first most common representing 22%.of patients. Bipolar Disorder, Autism Spectrum Disorder, and ADHD, followed at 14%, 12%, and 12% respectively. “Aggression towards others,” “Irritability” and “Tantrums/temper” were the most common target symptoms (representing 63.6% of patients).