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Concomitant psychotropic medication for youths.

Daniel J Safer¹, Julie Magno Zito, Susan DosReis

¹Division of Child Psychiatry, Johns Hopkins Medical Institutions, Baltimore, MD, USA. dsafer@jhmi.edu

The American Journal of Psychiatry

|March 4, 2003

Summary

The use of multiple psychotropic medications in children with emotional and behavioral disorders is common and increasing, but lacks robust scientific evidence. More research is needed to guide this practice.

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Area of Science:

Child and Adolescent Psychiatry
Pediatric Psychopharmacology
Behavioral Health

Background:

Emotional and behavioral disorders in youth are prevalent.
Psychotropic medication is frequently prescribed for these conditions.

Purpose of the Study:

To review the literature on the prevalence and patterns of concomitant psychotropic medication use in youths with emotional and behavioral disorders.

Main Methods:

A MEDLINE search (1996-2002) and reference review identified relevant studies.
Focused on identifying data regarding combined psychotropic medication for pediatric populations.

Main Results:

Evidence for concomitant psychotropic medication is primarily from case reports and small, nonblinded studies.

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In the mid-1990s, over 20% of outpatients and 40% of inpatients received multiple psychotropic medications, with rates increasing.

Prescribing patterns vary, with psychiatrists more likely to prescribe, and specific youth demographics (aggressive behavior, male, severe illness) more likely to receive them.

Conclusions:

There is a significant lack of systematic evidence to support the common practice of using multiple psychotropic medications in children.
Further research is crucial to understand and guide this inadequately studied area of child psychopharmacology.