Tuesday, January 30, 2018

Depression, ADHD, Anxiety Medications Not Overprescribed in Children, Study Shows

Psychiatric medications—especially stimulants and antidepressants—do not appear to be overprescribed to children and adolescents, according to a report published Monday in the Journal of Child and Adolescent Psychopharmacology.

“Among young people, the population level prescribing rates as well as age and sex distributions [of children who received stimulant and antidepressant prescriptions] are broadly consistent with known epidemiologic patterns of their established indications for ADHD, anxiety, and depression,” wrote lead author Ryan Sultan, M.D, of Columbia University and colleagues.

The researchers analyzed data contained in the 2008 IMS LifeLink LRx Longitudinal Prescription database on U.S. youth aged 3 to 24 years of age who had filled at least one prescription for stimulants, antidepressants, or antipsychotics during the study year. In total, the 2008 IMS LRx database included 131,291 younger children (aged 3 to 5), 2,140,289 older children (6 to 12), 2,163,202 adolescents (13 to 18), and 1,916,700 young adults (19 to 24) who filled at least one stimulant, antidepressant, or antipsychotic prescription.

The analysis revealed that 4.6% of older children and 3.8% of adolescents were prescribed stimulants; this is well below published national community ADHD prevalence estimates of 8.6%. Similarly, just 2.8% of adolescents, 1% of older children, and 0.1% of younger children received a prescription for an antidepressant; yet the prevalence rates for depression among adolescents alone range from 4% to 5%, while the prevalence rates for anxiety disorders in children and adolescents range from 15% to 20%.

Although annual antipsychotic prescription percentages were lower than antidepressant or stimulant percentages for all age groups, with a peak in adolescence (age 16 = 1.3%), it remains unclear whether antipsychotic prescribing is above or below prevalence rates of the disorders for which these medications are prescribed. “Patterns of antipsychotics are more complex and may reflect the heterogeneity of the approved and off-label conditions and disorders treated with this medication class,” the authors wrote.

“Overall, the findings provide some reassurance regarding population level prescribing patterns of psychotropic medications in youth in relation to the epidemiologic distribution of major child and adolescent mental disorders,” they wrote. “However, we should continue to monitor psychotropic medication prescriptions over time to assess whether U.S. prescribing practices remain broadly consistent with underlying disorder prevalence.”

For related information, see the Psychiatric News article “Prescribing for Mentally Ill Children Generally in Line With Best Practices.”

(Image: iStock/Nikodash)

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