title: Single and combined psychotropic medication use in a child and adolescent mental health service.
abstract: OBJECTIVE
  An audit of the extent and effectiveness of medication prescribing in a metropolitan child and adolescent mental health service (CAMHS) is presented, given the lack of data about medication effectiveness in CAMHS.
  
  
  METHODS
  The audit involved: (i) determining the rates of prescription of different medications, the symptoms, syndromes and diagnoses for which they were used, and the profession of the medication prescriber; and (ii) a semistructured interview of clinicians using combination pharmacotherapy enquiring about the rationale for its use and the outcomes obtained.
  
  
  RESULTS
  Two hundred and thirty-five patients using medication were included in the study. A range of medications were prescribed, both alone and in combination. Indications for combination therapy were a single medication being ineffective or associated with adverse effects. They were targeted at symptoms and were associated with no increase in adverse effects. Trainees did relatively little prescribing.
  
  
  CONCLUSIONS
  This study confirms earlier findings that medical practitioners are prescribing combination pharmacotherapy despite a lack of research to support this practice. Trainees working in CAMHS may be receiving inadequate experience in prescribing psychotropic medication.
authors.affiliation: Alfred Child and Adolescent Mental Health Service, Level 2, 999 Nepean Highway, Moorabbin Victoria 3189, Australia. emreed@optusnet.com.au
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Reed
authors.forename: Alasdair
authors.initials: A
authors.lastname: Vance
authors.forename: Ernest
authors.initials: E
authors.lastname: Luk
authors.forename: Kenneth
authors.initials: K
authors.lastname: Nunn
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000188:drug therapy*; D008605:Mental Health Services / Q000458:organization & administration*; D011619:Psychotropic Drugs / Q000008:administration & dosage / Q000145:classification / Q000627:therapeutic use*
chemical_list: D011619:Psychotropic Drugs