Mental Illness - More children are on prescription drugs for psychiatric disorders

27 января, 2003
The prevalence of psychotropic medication use among children and teenagers increased by two- to threefold from 1987 through 1996, according to a new study. Medical Letter on the CDC & FDA via NewsEdge Corporation : The prevalence of psychotropic medication use (drugs used to treat psychiatric disorders) among children and teenagers increased by two- to threefold from 1987 through 1996, according to a new study. Increased use of psychotropic medication (drugs normally used to treat psychiatric disorders, such as depression and other mood disorders, and attention deficit/hyperactivity disorder) for treating behavioral and emotional problems in children and adolescents has received widespread attention in the past decade. However, the extent of psychotropic medication treatment for youths receiving care in community settings has not been reliably reported. Julie Magno Zito, PhD, of the University of Maryland, Baltimore and colleagues examined changes in the psychotropic medication use for youths from 1987 to 1996. They analyzed data from nearly 900,000 youths younger than 20 years old enrolled in two U.S. health care systems, one in a midwestern state and one in a midatlantic state. The researchers found that the total use of psychotropic medications by youths increased 2- to 3- fold and included most classes of medication. They noted a rapid growth since 1991 in the use of drugs known as alpha-agonists, neuroleptics, and "mood stabilizer" anticonvulsants. The findings were published in the January 2003 issue of the Archives of Pediatric and Adolescent Medicine. The use of psychotropic drugs by youths on Medicaid almost always exceeded the rates of youths enrolled in health maintenance organizations (HMOs) by large margins, particularly alpha-agonists, neuroleptics, "mood stabilizer" anticonvulsants and lithium. Youths in HMOs had rates similar to Medicaid-insured youths for antidepressants and drugs known as hypnotic agents. Antidepressant medications were the second most commonly prescribed psychotropic medication by 1996, after stimulants. By 1996, the 10- to 14-year-old age group replaced the 5- to 9-year-olds as the largest group using psychotropic medication in the Medicaid populations studied. In the HMO population, 15- to 19-year-olds were the most prominent age group using psychotropics. "The 1-year period prevalence of psychotropic medication use grew to 6% of youths younger than 20 years, which represents a 2- to 3-fold increase in the decade from 1987 through 1996. Most of the temporal change occurred between 1991 and 1996. Medication classes generally showed a proportionally greater prevalence with increasing age, but 10- to 14-year-olds emerged as the Medicaid age group most likely to receive psychotropic medications while the 15- to 19-year-old group predominated among HMO medicated youths," wrote the authors (Arch Pediatr Adolesc Med, 2003;157:17-25; archpediatrics.com) This study was supported by a grant from the U.S. National Institute of Mental Health, Services Research and Clinical Epidemiology Branch, Bethesda, Maryland, and the Harold and Leila Y. Mathers Foundation, New York. In an accompanying editorial, Michael S. Jellinek, MD, of Massachusetts General Hospital, Boston, wrote, "The data reflect somewhat higher utilization rates for younger ages and possibly more serious disorders in Medicaid populations, which could support the hypothesis that mental illness in parents and the stressors of poverty add to the prevalence of child and adolescent psychiatric disorders in this subsample. An optimistic clinical perspective suggests that these data reflect a broader awareness of diagnostic criteria, less exclusive reliance on "talk therapy," and thoughtful efforts to extrapolate "off-label" from adult-based evidence to treat children and adolescents with serious mental health needs. "Given the scale of current psychotropic medication utilization, we have a responsibility to know what we are doing and the quality of our efforts. We need to ask ... this question: Are we prescribing the right psychotropic medications to the right children using the right treatment plan? Specifically, the work of Zito and colleagues reinforces our obligation to apply a quality assurance and research framework to our current pattern of utilization," Jellinek wrote. He concluded, "We need to have a more complete view in an ongoing, up-to-date time frame. We need a health plan-by-health plan quality assurance effort and a health services and basic research program" (Arch Pediatr Adolesc Med, 2003;157:14-16; archpediatrics.com). This article was prepared by Medical Letter on the CDC & FDA editors from staff and other reports. <> << Copyright ©2003 NewsRx.com >>
Разделы
Новости