title: Clinical practices in the pharmacological treatment of comorbid psychopathology in adolescents with alcohol use disorders.
abstract: This study examined the use of psychiatric medications in 277 adolescents in treatment for alcohol use disorders. Subjects were recruited from addictions treatment sites, psychiatric programs, and juvenile justice settings. Characteristics studied included the use of and indications for specific medications, changes in clinical practices from 1991 through 2000, and continuation of psychopharmacological treatment over a 1-year followup period. Among adolescents taking psychiatric medications at baseline (n = 51), indicated DSM-IV mental disorders were typically present, use of antidepressants was most common (n = 41), benzodiazepine prescription was rare, and about one third reported continuing pharmacological treatment at one-year followup. In those with comorbid major depressive disorder and alcohol use disorders (n = 110), antidepressant medication use increased significantly from 18% to 55% over the decade studied. The treatment setting did not significantly influence antidepressant prescribing practices. The common and increasing use of psychiatric medications in this population emphasizes the urgent need for empirically based clinical guidelines.
authors.affiliation: Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, 3811 O'Hara Street, Pittsburgh, PA 15213, USA. clarkdb@msx.upmc.edu
authors.forename: Duncan B
authors.initials: DB
authors.lastname: Clark
authors.forename: D Scott
authors.initials: DS
authors.lastname: Wood
authors.forename: Jack R
authors.initials: JR
authors.lastname: Cornelius
authors.forename: Oscar G
authors.initials: OG
authors.lastname: Bukstein
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Martin
mesh_terms: D000293:Adolescent; D000437:Alcoholism / Q000453:epidemiology / Q000534:rehabilitation*; D000928:Antidepressive Agents / Q000627:therapeutic use; D002648:Child; D015897:Comorbidity; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology; D004363:Drug Utilization; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology; D010818:Practice Patterns, Physicians'; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D014481:United States
chemical_list: D000928:Antidepressive Agents; D011619:Psychotropic Drugs