Psychoactive medication prescribing practices for U.S. children: gaps between research and clinical practice.
OBJECTIVE
To determine national pediatric prescribing practices for psychotropic agents and to examine these practices in view of the available evidence concerning their safety and efficacy in this age group.


METHODS
Prescribing data from 2 national databases based on surveys of office-based medical practices were determined and reviewed vis-à-vis available safety and efficacy evidence.


RESULTS
Data indicate that levels of psychotropic prescribing in children and adolescents are greatest for stimulants, resulting in nearly 2 million office visits and 6 million drug "mentions" in 1995. Selective serotonin reuptake inhibitors were the second most prescribed psychotropic agents, while anticonvulsant mood stabilizers (prescribed for a psychiatric reason), tricyclic antidepressants, central adrenergic agonists, antipsychotics, benzodiazepines, and lithium were also prescribed for a substantial number of office visits. Comparison of prescribing frequencies with available safety and efficacy data indicates significant gaps in knowledge for commonly used agents.


CONCLUSIONS
Most psychotropic agents require further sustained study to ensure appropriate health care expenditures and vouchsafe children's safety. Recommendations for researchers, parents, federal agencies, and industry are offered as a means to accelerate the pace of research progress.
Jensen
P S
PS
Child and Adolescent Research, NIMH, Bethesda, MD 20892-9669, USA.
Bhatara
V S
VS
Vitiello
B
B
Hoagwood
K
K
Feil
M
M
Burke
L B
LB
D000293:Adolescent; D000296:Adolescent Psychiatry / Q000639:trends*; D002648:Child; D002665:Child Psychiatry / Q000639:trends*; D016527:Drug Costs; D011307:Drug Prescriptions / Q000191:economics / Q000706:statistics & numerical data*; D005102:Health Expenditures; D006801:Humans; D001523:Mental Disorders / Q000188:drug therapy; D011619:Psychotropic Drugs / Q000191:economics / Q000627:therapeutic use*; D012106:Research / Q000639:trends; D014481:United States
D011619:Psychotropic Drugs