A recent study conducted by researchers at the University of Maryland has shed light on a concerning trend: growing numbers of children and adolescents are being prescribed multiple psychiatric drugs simultaneously. Published in JAMA Open Network, the study highlights the rise in polypharmacy, defined as the concurrent use of three or more different classes of psychiatric medications, including antidepressants, mood stabilizers, sedatives, and drugs for A.D.H.D. and anxiety.
The study, which analyzed prescribing patterns among Medicaid enrollees aged 17 or younger from 2015 to 2020 in a single undisclosed U.S. state, revealed a troubling trend. Over the study period, there was a significant 9.5 percent increase in the prevalence of polypharmacy among this demographic. Notably, this practice was observed to be more common among youths with disabilities or those in foster care.
While the study focused on data from a single state, previous research utilizing nationally weighted samples has also indicated a rise in polypharmacy among young people. Data from the National Ambulatory Medical Care Survey showed that in 2015, 40.7 percent of individuals aged 2 to 24 in the United States who were prescribed medication for A.D.H.D. also received a second psychiatric drug. This marked increase from 26 percent in 2006 underscores the growing prevalence of polypharmacy in this population.
However, the simultaneous use of multiple psychiatric medications in children and adolescents raises significant concerns. Despite the potential benefits of psychotropic medications in managing mental health conditions, many of these drugs have not been approved for use in young people. Moreover, the long-term impact of polypharmacy on brain development remains largely unknown, prompting calls for caution and further research in this area.
The study analyzed data from 126,972 individuals over the study period, revealing a steady increase in polypharmacy among Medicaid enrollees under the age of 17 in Maryland. In 2015, 4.2 percent of individuals in this demographic had overlapping prescriptions of three or more psychiatric medications, a figure that rose to 4.6 percent by 2020. Notably, the prevalence of polypharmacy was even higher among those in foster care, reaching 11.3 percent by 2020.
The findings underscore the importance of closely monitoring the use of psychotropic combinations, particularly among vulnerable populations such as youths enrolled in Medicaid and those in foster care. Given the potential risks associated with polypharmacy, healthcare providers must exercise caution and consider alternative treatment options when prescribing multiple psychiatric medications to children and adolescents.
While psychotropic medications can be effective in managing mental health conditions, experts emphasize the need for greater scrutiny and awareness surrounding their use, especially in young populations. As the prevalence of polypharmacy continues to rise, it is essential to prioritize the safety and well-being of children and adolescents by promoting evidence-based practices and ensuring appropriate monitoring of medication use.
In conclusion, the study’s findings highlight the urgent need for further research and guidance on the use of psychiatric medications in children and adolescents. By addressing the underlying factors driving the increase in polypharmacy and implementing strategies to mitigate its risks, healthcare providers can better support the mental health needs of young individuals while minimizing potential harm.
