title: Multiple psychotropic medication use for youths: a two-state comparison.
abstract: OBJECTIVE
  The aim of this study was to compare multiple psychotropic use among youths enrolled in two U.S. mid-Atlantic state Medicaid and state Children's Health Insurance Programs (SCHIP).
  
  
  METHODS
  Administrative data were used to examine multiple psychotropic use among youths less than 20 years of age and who were continuously enrolled in Medicaid or SCHIP programs in two states during 1999. Multiple psychotropic use referred to multiclass combinations and was defined by the number of months of multiple use. Main outcome measures were the prevalence of multiple psychotropic use and months of multiple use. Demographic and clinical characteristics, mental health visits, and common combinations were examined according to months of multiple use.
  
  
  RESULTS
  Among continuously enrolled youths, 21%-22% had at least one mental health-related visit, 8%-10% received a psychotropic medication, and 2%-3% received multiple psychotropic medications. Nearly one third (28%-30%) of youths with any psychotropic use received multiple medications, of which almost half was for 5-12 months. Multiclass use was more common in male, white, aged 10-14, disabled, and foster-care youths. Stimulants with antidepressants, antipsychotics, or alpha-agonists were the most common combinations.
  
  
  CONCLUSIONS
  Multiple use occurred in nearly one third of youths with any psychotropic treatment. Additional research is needed to investigate switching patterns and the effectiveness of combined pharmacotherapy.
authors.affiliation: Johns Hopkins Medicine, Division of Child and Adolescent Psychiatry, Baltimore, MD 21287, USA. sdosrei1@jhmi.edu
authors.forename: Susan
authors.initials: S
authors.lastname: dosReis
authors.forename: Julie M
authors.initials: JM
authors.lastname: Zito
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Safer
authors.forename: James F
authors.initials: JF
authors.lastname: Gardner
authors.forename: Karen B
authors.initials: KB
authors.lastname: Puccia
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Owens
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008484:Medicaid; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D013221:State Health Plans; D014481:United States
chemical_list: D011619:Psychotropic Drugs