Concomitant pharmacotherapy among youths treated in routine psychiatric practice.
OBJECTIVE
The aim of this study was to assess rates and correlates of concomitant pharmacotherapy in children and adolescents treated by psychiatrists in a broad range of clinical settings.


METHODS
Cross-sectional data on 392 child and adolescent patients aged 2-17 years from the 1997 and 1999 American Psychiatric Practice Research Network Study of Psychiatric Patients and Treatments were used, and weighted estimates are provided.


RESULTS
Findings indicate that 84% of child and adolescent patients received one or more psychopharmacologic medications; 52% of patients treated with medications received concomitant pharmacotherapy (i.e., two or more medications). Patients who were treated with psychopharmacologic treatments received a median of 2 medications (range, 1-6). Highest rates of concomitant pharmacotherapy were among patients with bipolar disorder (87%). Correlates of concomitant pharmacotherapy included: (1) having a diagnosis of bipolar disorder, (2) having co-occurring Axis I or II disorders or general medical conditions, and (3) currently receiving treatment in an inpatient setting.


CONCLUSIONS
Over 40% of child and adolescent patients of psychiatrists were prescribed two or more psychopharmacologic medications. Patients with chronic and clinically complex conditions were more likely to receive concomitant pharmacotherapy. Most often, efficacy of U.S. Food and Drug Administration (FDA)-approved medications has been examined as monotherapy, and cautions on drug interactions and off-label use derived from multiple sources accompany each product. With high rates of concomitant pharmacotherapy among children and adolescents in psychiatric care, additional research on efficacy and safety of this treatment strategy is necessary.
Duffy
Farifteh Firoozmand
FF
American Psychiatric Institute for Research and Education, Arlington, VA 22209, USA. fduffy@psych.org
Narrow
William E
WE
Rae
Donald S
DS
West
Joyce C
JC
Zarin
Deborah A
DA
Rubio-Stipec
Maritza
M
Pincus
Harold Alan
HA
Regier
Darrel A
DA
D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D002665:Child Psychiatry / Q000706:statistics & numerical data*; D002675:Child, Preschool; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004358:Drug Therapy; D004359:Drug Therapy, Combination; D006801:Humans; D016015:Logistic Models; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology*; D016017:Odds Ratio; D011619:Psychotropic Drugs / Q000008:administration & dosage*
D011619:Psychotropic Drugs