Study Refutes Claims of Inappropriate Psychotropic Prescribing in Youth

Over the last several years there have been charges—often based on anecdotal reports—that children and adolescents are frequently prescribed psychotropic medications for conditions they don't have or disorders for which a particular medication is not indicated. However, a new study by researchers at the National Institute of Mental Health (NIMH) of more than 10,000 U.S. teenagers refutes such claims. Their finding were published online Monday in the Archives of Pediatric and Adolescent Medicine. The research team, headed by Kathleen Merikangas, Ph.D., chief of the Genetic Epidemiology Research Branch at NIMH, collected data on specific medication use in the National Comorbidity Study—Adolescent Supplement, which is a face-to-face survey of youth aged 13 to 18. Their data focused on teens who met criteria for a variety of mental disorders; medications included antipsychotics, antidepressants, and stimulants.

They found that among teens meeting criteria for any mental disorder, just 14.2% said that they had been treated with a psychotropic medication. Those with ADHD had the highest rates of prescribed medication use at 31%, while 19.7% with a mood disorder like depression or bipolar disorder were taking psychotropic medication. Among those with eating disorders, about 19% were taking such drugs, and 11.6% of teens with anxiety disorders reported taking these medication. Very few reported use of antipsychotic medications. In addition, 2.5% of respondents who did not have a diagnosed mental disorder were prescribed a psychotropic medication, of whom 78% had a previous mental or neurodevelopmental disorder and associated psychological distress or impairment.

Thus, they concluded, "most adolescent youth who are taking psychotropic medications have serious behavioral, cognitive, or emotional disturbances."

For a comprehensive review of psychotropic medications in young patients, see Clinical Manual of Child and Adolescent Psychopharmacology, Second Edition, new from American Psychiatric Publishing.

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