Abstract
The purpose of the study was three-fold: (1) to estimate the national trends in antipsychotic (AP) polypharmacy among 6- to 24-year-old patients in the U.S.; (2) to identify frequently used AP agents and mental disorder diagnoses related to AP polypharmacy; and (3) to assess the strength of association between AP polypharmacy and patient/provider characteristics. We used publicly available ambulatory health care datasets to evaluate AP polypharmacy in office-based or hospital outpatient department settings to conduct a cross-sectional study. First, national visit rates between 2007 and 2011 were estimated using sampling weights. Second, common diagnoses and drugs used in AP polypharmacy were identified. Third, a multivariate logistic regression model was developed to assess the strength of association between AP polypharmacy and patient and provider characteristics. Between 2007 and 2011, approximately 2% of office-based or hospital outpatient department visits made by 6- to 24-year-old patients included one or more AP prescriptions. Of these visits, 5% were classified as AP polypharmacy. The most common combination of AP polypharmacy was to use two or more second-generation APs. Also, bipolar disorder and schizophrenia were the two most frequent primary mental disorder diagnoses among AP polypharmacy visits. The factors associated with AP polypharmacy were: older age (young adults), black, having one or more non-AP prescriptions, and having schizophrenia or ADHD.
Highlights
Over the last two and half decades, a wide variety of psychotropic medications have reinvented psychiatric therapy, especially for children and young adults
6- to 24-year-old patients in the U.S.; (2) to identify frequently used AP agents and diagnoses related to AP polypharmacy; and (3) to assess the strength of association between AP polypharmacy and patient/provider characteristics
Food and Drug Administration (FDA), and aripiprazole was approved for the treatment of autistic spectrum disorder
Summary
Over the last two and half decades, a wide variety of psychotropic medications have reinvented psychiatric therapy, especially for children and young adults. The profession of medicine has observed an increased frequency in the use of antipsychotic (AP) medication in the age group [1,2,3,4]. First-generation, typical APs were developed in the 1950s, and second-generation APs (i.e., known as atypical APs) were developed in the 1990s. Second-generation APs boasted reduced extrapyramidal symptoms and other health problems caused by the use of first-generation APs [5,6]. The overall utilization of APs has increased significantly over time in patients of all ages, including children [7,8,9,10,11,12,13,14,15,16]. By 2002, this statistic rose drastically to include as many as 39.4 per 1000 children [17]
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