The number of children and adolescents who take multiple types of psychiatric medications has risen significantly since 1999 in the United States, driven mainly by prescriptions to youth diagnosed with attention-deficit/hyperactivity disorder (ADHD). These findings were published today in JAMA Pediatrics.
“The use of medication from two or more psychotropic classes, i.e., polypharmacy, has increased among U.S. youth despite limited evidence of efficacy and mounting safety concerns,” wrote Chengchen Zhang, M.P.H., of the University of Maryland School of Pharmacy and colleagues.
Zhang and colleagues analyzed data from the Medical Expenditure Panel Surveys (MEPS) collected between 1990 and 2015. The MEPS is a national survey that tracks various trends in health care use and expenditures.
The researchers examined the number of youth up to age 18 years who received prescriptions for at least three classes of psychiatric medications each year of the survey. The medication classes included in the analysis were stimulants, antidepressants, mood stabilizers, antipsychotics, anxiolytics, sedatives, and α-agonists. The data were grouped into three blocks: 1999-2004, 2005-2010, and 2011-2015.
Zhang and colleagues found that the number of youth prescribed three or more classes of psychiatric medications increased from 101,836 between 1999 and 2004 to 222,955 between 2005 and 2010 to 293,492 between 2011 and 2015. Stimulants were the most common medication prescribed to youth treated with polypharmacy across all three time periods. More than 80% of the youth had an ADHD diagnosis.
The use of antipsychotics by youth prescribed multiple psychiatric medications rose sharply during this period (from 38% of youth receiving polypharmacy between 1999 and 2004 to 75% of youth between 2011 and 2015). In contrast, there was a significant decline in mood stabilizer use (from 61% of youth between 1999 and 2004 to 38% of youth between 2011 and 2015). Between 2011 and 2015, the most common three-drug combination was stimulants, antipsychotics, and α-agonists, which were prescribed to nearly 22% of all youth in the analysis.
To read more on this topic, see the Psychiatric News article “Education Can Reduce Antipsychotic Polypharmacy.”
(Image: iStock\Brian)
Candidates for APA Area 4 Trustee Announced
The APA Nominating Committee, chaired by Immediate Past President Bruce Schwartz, M.D., has announced the candidates for Area 4 Trustee for APA’s 2021 election. The candidates are Theadia LaRue Carey, M.D., of Southfield, Minn., and Cheryl D. Wills, M.D., of Cleveland. The candidates were approved by the Board of Trustees on October 30.
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