The news
An increasing number of children and adolescents are prescribed multiple psychiatric medications to take simultaneously, according to a new study by researchers at the University of Maryland. The phenomenon is growing despite warnings that combinations of psychotropic drugs in young people have not been tested for safety or studied for their impact on the developing brain.
The study, published Friday in JAMA Open Network, examined prescribing patterns among patients 17 or younger enrolled in Medicaid from 2015 to 2020 in a single U.S. state that the researchers declined to name. In this group, there was a 9.5 percent increase in the prevalence of “polypharmacy,” which the study defines as taking at least three different classes of psychiatric medications, including antidepressants, anticonvulsants mood stabilizers, sedatives, and ADHD medications and anti-anxiety medications.
The big picture
The study only covered one state, but status data have been used in the past to explore this question, in part because of the relative ease of collecting data from Medicaid, the state-administered health insurance program.
At the same time, some research using nationally weighted samples has found the increasing prevalence of polypharmacy among young people. A recent article attracted data from the National Ambulatory Medical Care Survey and found that in 2015, 40.7 percent of people ages 2 to 24 in the United States who were taking one medication for ADHD were also taking a second psychiatric medication. This figure was up from 26 percent in 2006.
The latest data from University of Maryland researchers shows that, at least in one state, the practice continues to grow and “was significantly more likely among youth with disabilities or in foster care,” the new study notes.
Mental health experts have said that psychotropic medications can be very helpful and that doctors have the discretion to prescribe what they deem appropriate. Some experts worry that many drugs used in commonly prescribed cocktails have not been approved for use in young people. And it’s unclear how using multiple psychotropic medications together affects long-term brain development.
Numbers
The latest study looked at data from 126,972 people during the study period. It found that in 2015, 4.2 percent of Medicaid enrollees under the age of 17 in Maryland had overlapping prescriptions of three or more different classes of psychiatric medications. This figure increased to 4.6% in 2020.
The figures were higher for those in foster care, where the prevalence of polypharmacy increased from 10.8 percent to 11.3 percent.
“The findings highlight the importance of monitoring the use of psychotropic combinations, particularly among vulnerable populations, such as youth enrolled in Medicaid who have disabilities or are in foster care,” the study concludes.
