Document Detail


National trends in child and adolescent psychotropic polypharmacy in office-based practice, 1996-2007.
MedLine Citation:
PMID:  20855045     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Jonathan S Comer; Mark Olfson; Ramin Mojtabai
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.     Date:  2010-09-01
Journal Detail:
Title:  Journal of the American Academy of Child and Adolescent Psychiatry     Volume:  49     ISSN:  1527-5418     ISO Abbreviation:  J Am Acad Child Adolesc Psychiatry     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-21     Completed Date:  2011-01-26     Revised Date:  2012-05-07    
Medline Journal Info:
Nlm Unique ID:  8704565     Medline TA:  J Am Acad Child Adolesc Psychiatry     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1001-10     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
Affiliation:
College of Physicians and Surgeons, Columbia University, and the New York State Psychiatric Institute, New York, USA. jcomer@bu.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Ambulatory Care / trends
Anticonvulsants / therapeutic use
Antidepressive Agents / therapeutic use
Antimanic Agents / therapeutic use
Antipsychotic Agents / therapeutic use
Attention Deficit Disorder with Hyperactivity / drug therapy,  epidemiology
Central Nervous System Stimulants / therapeutic use
Child
Comorbidity
Drug Therapy, Combination
Drug Utilization / statistics & numerical data,  trends
Female
Humans
Insurance, Health, Reimbursement / trends
Male
Medical Assistance / trends
Mental Disorders / drug therapy*,  epidemiology*
Physician's Practice Patterns / trends*
Primary Health Care / trends
Psychiatry / trends
Psychotropic Drugs / therapeutic use*
Statistics as Topic
United States
Grant Support
ID/Acronym/Agency:
T32 MH016434/MH/NIMH NIH HHS; U18 HS016097/HS/AHRQ HHS
Chemical
Reg. No./Substance:
0/Anticonvulsants; 0/Antidepressive Agents; 0/Antimanic Agents; 0/Antipsychotic Agents; 0/Central Nervous System Stimulants; 0/Psychotropic Drugs
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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