Multiple Psychotropic Medication Use for Youths: A Two-State Comparison (original) (raw)
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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.
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.
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.
Psychiatric services (Washington, D.C.), 2018
This study estimated the prevalence, time trends, and state-level variation of same- and multiclass psychotropic polypharmacy among youths in Medicaid fee-for-service plans. Using pharmacy records from 29 Medicaid states from 1999 to 2010, the authors constructed ten two-year cohorts of beneficiaries between ages 0 and 17 years who received at least one psychotropic to treat a mental disorder. Polypharmacy was defined as any period in which dispensed days' supply of psychotropics overlapped for more than 45 days. Same- and multiclass psychotropic polypharmacy prevalence was stratified by age and state. A total of 692,485 children were included across each two-year cohort. The prevalence of any-class and multiclass psychotropic polypharmacy grew steadily, from 21.2% and 18.8% in 1999-2000 to 27.3% and 24.4% in 2009-2010, respectively. The prevalence increased with older age, with highest estimates for late adolescents. For same-class psychotropic polypharmacy, a constant upward t...
Prevalence Variations in Psychotropic Treatment of Children
Journal of Child and Adolescent Psychopharmacology, 1998
This study was undertaken to clarify several aspects of the estimation of prevalence of three commonly use pédiatrie psychotropic agents, namely, methylphenidate, desipramine, and imipramine. The study aims are threefold: (1) to show the variability of drug prevalence by comparing estimates from three data sources; (2) to show the misleading impression that can be created by reporting drug prevalence estimates based on counts of prescriptions rather than persons; (3) to show the utility of gender-by-age-specific prevalence of drug use as a marker for diagnosis. Two data sources that yield population-based prescription estimates were available: 1991 Medicaid administrative claims data for prescriptions from a mid-Atlantic state and 1991 prescription records of the northwest region of Kaiser Permanente, a staff-model health maintenance organization (HMO). Another source of data consists of the 1991 National Ambulatory Medical Care Survey, which records medication information reported during physician office visits. Data analysis consists of quantitative estimates of (1) drug prevalence from each source; (2) the ratio of prescription claims to persons; and (3) the proportion of drug use according to age and gender. Methylphenidate and desipramine prevalence had a twofold greater use among state Medicaid enrólleos compared with HMO enrollees. Average claims-to-person ratios of 5:1 suggest better accuracy using persons with medication rather than prescription counts. Gender-by-age-specific prevalence rates showed that 75% of the drug use for desipramine among those less than 15 years old was found among males, whereas 75% of the desipramine use among those 15 or older was found among females, suggesting its use for the treatment of attention deficithyperactivity disorder among young males and for depression among older females. The
Journal of Child and Adolescent Psychopharmacology, 2010
Objective: The aim of this study was to examine rates of psychotropic medication use over time among a national probability sample of youths involved with child welfare=child protective services (CW=CPS) in the National Survey of Child and Adolescent Well-Being (NSCAW). Methods: Growth mixture modeling was used to classify 2,521 youths into groups based on individual medication use trajectories. Determinants associated with groupings were examined using logistic regression. Results: Overall, 22% of youths used medications over 3 years. Three groups were identified: (1) Low medication use (85%, n ¼ 2,057), where medication was used rarely or never; (2) increasing medication use, where medication was commonly started after investigation (4%, n ¼ 148); and (3) high medication use, where medication use was endorsed over multiple study waves (12%, n ¼ 316). On multivariate modeling, physical abuse predicted membership in the increasing-use group (reference group, low use); Caucasian (versus African American) and need predicted membership in the high-use group (reference group, low use). Male gender was associated with membership in both the increasing-use and high-use groups (reference group, low use). Age and abuse type (physical abuse, neglect) demonstrated complex relationships with group membership. Conclusions: Psychotropic medication use trajectories for children in child welfare vary and are best understood when disaggregated into distinct subpopulations.
Concomitant Psychotropic Medication for Youths
American Journal of Psychiatry, 2003
This study reviewed the clinical research and practice literature relating to the prevalence and patterns of concomitant psychotropic medication given to youths with emotional and behavioral disorders. Method: A MEDLINE search from 1996 through spring 2002, including a review of references from relevant published articles and reports, was undertaken to identify available information on concomitant psychotropic medication for youths.
Psychotropic Medication Patterns Among Youth in Foster Care
PEDIATRICS, 2008
Financial Disclosure: Drs Zito and Safer have received consulting fees from the Office of the Texas Comptroller of Public Accounts. The other authors have indicated they have no financial relationships relevant to this article to disclose.