Format

Send to

Choose Destination
J Am Acad Child Adolesc Psychiatry. 2010 Oct;49(10):1001-10. doi: 10.1016/j.jaac.2010.07.007. Epub 2010 Sep 1.

National trends in child and adolescent psychotropic polypharmacy in office-based practice, 1996-2007.

Author information

1
College of Physicians and Surgeons, Columbia University, and the New York State Psychiatric Institute, New York, USA. jcomer@bu.edu

Abstract

OBJECTIVE:

To examine patterns and recent trends in multiclass psychotropic treatment among youth visits to office-based physicians in the United States.

METHOD:

Annual data from the 1996-2007 National Ambulatory Medical Care Surveys were analyzed to examine patterns and trends in multiclass psychotropic treatment within a nationally representative sample of 3,466 child and adolescent visits to office-based physicians in which a psychotropic medication was prescribed.

RESULTS:

There was an increase in the percentage of child visits in which psychotropic medications were prescribed that included at least two psychotropic classes. Across the 12 year period, multiclass psychotropic treatment rose from 14.3% of child psychotropic visits (1996-1999) to 20.2% (2004-2007) (adjusted odds ratio [AOR] = 1.89, 95% confidence interval [CI] = 1.22-2.94, p < .01). Among medical visits in which a current mental disorder was diagnosed, the percentage with multiclass psychotropic treatment increased from 22.2% (1996-1999) to 32.2% (2004-2007) (AOR = 2.23, 95% CI = 1.42-3.52, p < .001). Over time, there were significant increases in multiclass psychotropic visits in which ADHD medications, antidepressants, or antipsychotics were prescribed, and a decrease in those visits in which mood stabilizers were prescribed. There were also specific increases in co-prescription of ADHD medications and antipsychotic medications (AOR = 6.22, 95% CI = 2.82-13.70, p < .001) and co-prescription of antidepressant and antipsychotic medications (AOR = 5.77, 95% CI = 2.88-11.60, p < .001).

CONCLUSIONS:

Although little is known about the safety and efficacy of regimens that involve concomitant use of two or more psychotropic agents for children and adolescents, multiclass psychotropic pharmacy is becoming increasingly common in outpatient practice.

PMID:
20855045
PMCID:
PMC2952543
DOI:
10.1016/j.jaac.2010.07.007
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center