title: Psychotropic drug use among preschool children in the Medicaid program from 36 states.
abstract: OBJECTIVE
  We determined the prevalence of and indications for psychotropic medication among preschool children in Medicaid.
  
  
  METHODS
  We obtained 2000 to 2003 Medicaid Analytic Extract data from 36 states. We followed children in 2 cohorts, born in 1999 and 2000, up to age 4 years. We used logistic regression to model odds of receiving medications for (1) attention-deficit disorder/attention-deficit hyperactivity disorder, (2) depression or anxiety, and (3) psychotic illness or bipolar.
  
  
  RESULTS
  Overall, 1.19% of children received at least 1 psychotropic drug. Medications for attention-deficit disorder/attention-deficit hyperactivity disorder treatment were most common (0.61% of all children), followed by depression or anxiety (0.59%) and psychotic illness or bipolar (0.24%). Among children, boys, those of other or unknown race compared with White, and those with other insurance compared with fee for service-only had higher odds of receiving a prescription (odds ratio [OR]=1.80 [95% confidence interval (CI)=1.74, 1.86], 1.75 [corrected] [1.66, 1.85], and 1.14 [1.01, 1.28], respectively), whereas Black and Hispanic children had lower odds (OR=0.51 [95% CI=0.48, 0.53] and 0.37 [0.34, 0.39], respectively).
  
  
  CONCLUSIONS
  Preschoolers are receiving psychotropic medications despite limited evidence supporting safety or efficacy. Future research should focus on implementing medication use practice parameters in infant and toddler clinics, and expanding psychosocial interventions for young children with behavioral problems.
authors.affiliation: Lauren D. Garfield, Derek S. Brown, Raven E. Ross, Ginger E. Nicol, and Ramesh Raghavan are with Washington University, St Louis, MO. Benjamin T. Allaire is with RTI International, Research Triangle Park, NC.
authors.forename: Lauren D
authors.initials: LD
authors.lastname: Garfield
authors.forename: Derek S
authors.initials: DS
authors.lastname: Brown
authors.forename: Benjamin T
authors.initials: BT
authors.lastname: Allaire
authors.forename: Raven E
authors.initials: RE
authors.lastname: Ross
authors.forename: Ginger E
authors.initials: GE
authors.lastname: Nicol
authors.forename: Ramesh
authors.initials: R
authors.lastname: Raghavan
mesh_terms: D000367:Age Factors; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D001921:Brain / Q000187:drug effects* / Q000254:growth & development; D002675:Child, Preschool; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D004363:Drug Utilization / Q000639:trends; D005260:Female; D006801:Humans; D007223:Infant; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D056687:Off-Label Use / Q000706:statistics & numerical data; D064226:Prescription Drug Diversion; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000592:standards / Q000627:therapeutic use*; D014481:United States / Q000453:epidemiology
chemical_list: D011619:Psychotropic Drugs