Initiation and Change of Psychotropic Medication Regimens among Adolescents in Inpatient Care (original) (raw)
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Psychotropic Medication Utilization in a Child and Adolescent Mental Health Service
JOURNAL OF CHILD AND ADOLESCENT PSYCHOPHARMACOLOGY, 2006
Objectives: This study aimed to identify rates and correlates of psychotropic drug utilization in children and adolescents in inpatient and outpatient settings. Methods: A retrospective chart review examined 122 inpatient and 126 outpatient charts from a metropolitan child and youth mental health service in Brisbane, Australia. Results: Inpatients received more psychotropic medication than outpatients (71% vs. 25%; p < 0.01). Patients receiving medication were older, had longer hospital admissions, and more complex presentations, including history of abuse or suicide attempts and more diagnoses (all p < 0.01). Selective serotonin reuptake inhibitors (SSRIs) were the most frequently used drug class (44% inpatients; 14% outpatients), primarily indicated for mood disorders (31%). SSRIs and newer antidepressants (ADs) were used more frequently in patients with a high suicide risk (p < 0.01). Atypical antipsychotics (APs) were also used (inpatients 23%; outpatients 3%), primarily for behavioral disturbances. Half of those receiving medication (51%) received polypharmacy (>1 concurrent drug), with up to four drugs used at one time. Rates of polypharmacy were highest among patients receiving antipsychotics. Conclusions: Use of psychotropic medication is frequent in this population. Future research should initially focus on inpatients and intensive treatment settings and examine both safety and efficacy of interventions for depression in young people, atypical antipsychotics for behavioral disturbances, and polypharmacy.
Patterns of Psychotropic Medication at Admission for Youth in Residential Care
Journal of Child and Family Studies, 2016
High levels of psychotropic medication use and polypharmacy are common for emotionally and behaviorally troubled youth entering residential care. Polypharmacy has often been characterized as an especially serious problem in this vulnerable population. Latent Class Analysis was used to identify medication subgroups for 636 youth in an intensive residential program. Additionally, auxiliary analyses (e.g., diagnoses, demographics, expressed problem behaviors) were used to identify the personal and behavioral attributes associated with individuals in each of the latent classes. Three distinct medication patterns emerged: low/no psychotropic medication, the combination of antidepressant and antipsychotic medications, and multiple psychotropic medications. The latent classes were significantly different from one another on 12 of the 14 variables, helping explicate how patient and clinical characteristics underlie patterns of psychotropic medication use. Findings of this study, combined with additional research, hold promise for leading to improved, youth-centered prescribing practices. Our findings also highlight the need for careful monitoring of the types and range of medications that some youth are prescribed, and research on how youth with certain background characteristics are more likely to get prescribed multiple psychotropic medications. For youth experiencing higher levels of psychotropic polypharmacy, medication regimens need thoughtful reassessment using the principle of sufficiency as the foundation for medication management.
Psychiatric services (Washington, D.C.), 2004
This study estimated the overall rate of use of psychotropic medications among youths (less than 18 years of age) in the U.S. mental health service system and compared rates of use for youths with a single diagnosis and those with co-occurring diagnoses. Results were based on nationally representative client data from the 1997 Client/Patient Sample Survey. On any given day, about one-third (32.5 percent) of the 559,769 youths in the service system received psychotropic medication. Youths with co-occurring diagnoses were significantly more likely to receive medication than youths with a single diagnosis. Future research on best practices may be most effective if the role of medication in the treatment of single and co-occurring disorders among youths is evaluated.
Medicina, 2019
Background: In recent years, patterns of the use of psychotropic drugs vary with increasing rates of psychiatric presentation and diagnosis in children and adolescents. Purpose: In this study, we aimed to investigate distributions of current psychiatric symptoms and diagnosis, patterns of the use of psychotropic drugs, and differences according to age and gender in patients presented to a child and adolescent outpatient clinic. Methods: All patients aged between 0 and 18 years presenting to a child and adolescent psychiatry outpatient clinic between November 1, 2017 and November 1, 2018 were included in the study. Files of all patients were examined in detail, and patients’ demographic characteristics, symptoms, psychiatric diagnoses established according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), psychotropic drugs initiated, and side effect profiles were recorded. Psychiatric symptoms and diagnostic features of the patients were dete...
Journal of Child and Family Studies, 2010
At the time of entry into residential treatment, many youth have prescriptions for one or more psychotropic medications. It is not well understood why some youth are prescribed only one psychotropic medication while others may be prescribed more. We sought to determine if differences existed between youth entering residential treatment with monopharmacy (n = 77) versus youth entering with polypharmacy (n = 103). Youth were compared across demographic, family, behavioral, mental health, and psychotropic medication variables. The only significant differences identified were related to the numbers of youth with prescriptions across the different psychotropic classes. As would be expected, youth experiencing polypharmacy were more likely to have prescriptions within each class. Implications, limitations, and recommendations for future research are discussed.
Youth at entry to residential treatment: Understanding psychotropic medication use
Children and Youth Services Review, 2012
Youth entering residential treatment often present with complex mental health and behavioral needs. As a result, it is not surprising that many of these youth have active prescriptions for psychotropic medications. What is surprising, however, is that very little is known about how psychotropic medications are used for youth who enter residential treatment. Therefore, the purpose of this study was to gain a better understanding of psychotropic medication use for youth at their time of entry to residential treatment through the examination of archival data. Data suggested that the youth in this sample had high levels of emotional and behavioral difficulties and that many had active psychotropic prescriptions. Patterns of use differed slightly from those identified with previous samples, but several clinical and non-clinical factors were identified that were predictive of psychotropic medication use. Findings and implications are discussed in detail.
Medication prescribing practices in a child and adolescent psychiatry outpatient clinic
Child: Care, Health and Development, 2007
Background The aim of this study was to evaluate the medication prescribing practices for children who had attended a child and adolescent psychiatry outpatient clinic in Turkey. Methods A retrospective chart review of consecutive new patients admitted to a child and adolescent psychiatry outpatient clinic of university hospital within 6 months was performed. Results Male/female ratio of 822 charts examined was 1.75. Over activity and/or distractibility were the most common presenting complaints and attention-deficit hyperactivity disorder was the most common disorder. Approximately one-fourth (24.0%) of children were prescribed psychotropic medications. Initiation time of psychotropic medication was one of the first two visits in 65% of the children who were prescribed medication. The most commonly prescribed medications were in descending order of prescribing frequency: selective serotonin reuptake inhibitors, tricyclic antidepressants, atypical antipsychotics and psychostimulants. About 54.2% of depressed children were prescribed selective serotonin reuptake inhibitors and 24.3% of children with attention-deficit hyperactivity disorder were prescribed psychostimulant treatment. Among children who used at least one psychotropic medication, the rate of co-prescription was 10.7%. Conclusion It was found that the use of selective serotonin reuptake inhibitors and methylphenidate in children has become widespread. The results of our study may be helpful in improving treatment services in child and adolescent psychiatry.
Psychotropic Practice Patterns for Youth
Archives of Pediatrics & Adolescent Medicine, 2003
Objective: To examine changes in the full spectrum of psychotropic medication treatment for youths from 1987 to 1996.