Prescription Of Psychotropic Medication Research Articles

Common mental health diagnoses arising from or coinciding with menopausal transition and prescribing of SSRIs/SNRIs medications and other psychotropic medications.

Women with menopausal transition (MT) have an elevated risk of experiencing common mental health diagnoses (CMHD: depression or anxiety). There is no recent data comparing the rate, and treatment, of CMHD between men and women. In this population-based study, incidence rates (IR) per 100 person-years-at-risk (PYAR) for men and women ≥45years registered with an UK primary care practice between 2010 and 2021 were estimated. Incidence rate ratios (IRR) with 95% confidence intervals (CIs) of CMHD were estimated using men as a reference. We measured first prescriptions for psychotropic medications received within 12months after CMHD. For selective serotonin reuptake inhibitors (SSRIs) /selective norepinephrine reuptake inhibitors (SNRIs), we measured the IR of prescribing per 100 PYAR, by 10-year bands. Proportion of SSRIs/SNRIs prescribing was estimated per 100 persons. Rates of anxiety and depressive disorders were 1.68 and 1.69 per 100 PYAR in women aged 45-54years-old compared to 0.91 and 1.20 per 100 PYAR in men, with IRR of 1.84 (95% CI 1.72-1.97) and 1.44 (1.35-1.53) respectively. SSRIs/SNRIs were the most prescribed medication; in 2021, IRs for SSRIs/SNRIs were 13.4 per 100 PYAR in both sexes. In 2021, the proportion of SSRIs/SNRIs prescribing was 50.67 per 100 women and 41.91 per 100 men. MT is assumed based on women's age as menopause onset is rarely recorded in primary care databases. Women ≥45years experienced more CMHD compared to men, especially 45-54years-olds, which coincides with MT. The proportion of SSRIs/SNRIs prescribing was higher in women.

A cross-sectional study of recent patterns of psychotropic medication use in children and adolescents in Ireland.

There has been a global rise in prescribing of psychotropic medications. Variations in patterns of use, according to age, gender and drug class type, have also been reported. This study aimed to analyse patterns of psychotropic medication use in Ireland according to age group, gender and drug class type, to determine if variations exist, and identify specific nuances to be addressed in future research. A retrospective, repeated, cross-sectional study of the Irish pharmacy claims database (community setting dispensing data) was conducted. Yearly prevalence of children/adolescents receiving dispensed psychotropic medications was analysed from January 2017 to December 2021, across years, age groups (5-15, 5-11 and 12-15 years), gender and drug class type. All available data were used. Yearly prevalence was the mean number of patients receiving medication per month per 1000 eligible population during a given year. Negative binomial regression was used to examine association of year, age group and gender on prevalence. In the 12-15 years group, prevalence for all selected psychotropic medications in 2021 in males was almost twice that in females (19.92/1000 vs 10.62/1000). In the 5-11 years group, prevalence was three times higher in males than females (7.56/1000 vs 2.49/1000). Overall, there was a higher rate of increase in females and higher usage in older children. This study found variations in psychotropic medication use in children/adolescents, depending on age, gender and drug class type. Further research is needed to determine whether variations have resulted in treatment disparities for certain cohorts.

Nationwide burden of sudden cardiac death among patients with a psychiatric disorder

BackgroundPatients with psychiatric disorders have increased all-cause mortality compared with the general population. Previous research has shown that there is a fourfold increased risk of sudden cardiac death (SCD) among...

Model of integrated mental health video consultations for people with depression or anxiety in primary care (PROVIDE-C): assessor masked, multicentre, randomised controlled trial

ObjectiveTo evaluate whether an integrated mental health video consultation approach (PROVIDE model) can improve symptoms compared with usual care in adults with depression and anxiety disorders attending primary care.DesignAssessor masked,...

Long-read sequencing of CYP2D6 may improve psychotropic prescribing and treatment outcomes: A systematic review and meta-analysis.

The enzyme expression (i.e. phenotype) of the Cytochrome P450 2D6 (CYP2D6) gene is highly relevant to the metabolism of psychotropic medications, and therefore to precision medicine (i.e. personalised prescribing). This review aims to assess the improvement in CYP2D6 phenotyping sensitivity (IPS) and accuracy (IPA) offered by long-read sequencing (LRS), a new genetic testing technology. Human DNA samples that underwent LRS genotyping of CYP2D6 in published, peer-reviewed clinical research were eligible for inclusion. A systematic literature search was conducted until 30 September 2023. CYP2D6 genotypes were translated into phenotypes using the international consensus method. IPS was the percentage of non-normal LRS CYP2D6 phenotypes undetectable with FDA-approved testing (AmpliChip). IPA was the percentage of LRS CYP2D6 phenotypes mischaracterised by non-LRS genetic tests (for samples with LRS and non-LRS data). Six studies and 1411 samples were included. In a meta-analysis of four studies, IPS was 10% overall (95% CI = (2, 18); n = 1385), 20% amongst Oceanians (95% CI = (17, 23); n = 582) and 2% amongst Europeans (95% CI = (1, 4); n = 803). IPA was 4% in a large European cohort (95% CI = (2, 7); n = 567). When LRS was used selectively (e.g. for novel or complex CYP2D6 genotypes), very high figures were observed for IPS (e.g. 88%; 95% CI = (72, 100); n = 17; country = Japan) and IPA (e.g. 76%; 95% CI = (55, 98); n = 17; country = Japan). LRS improves CYP2D6 phenotyping compared to established genetic tests, particularly amongst Oceanian and Japanese individuals, and those with novel or complex genotypes. LRS may therefore assist in optimising personalised prescribing of psychotropic medications. Further research is needed to determine associated clinical benefits, such as increased medication safety and efficacy.

Impact of the COVID-19 pandemic on psychotropic prescribing: a systematic review

ObjectivesThe global prevalence of mental health disorders has risen significantly since the beginning of the COVID-19 pandemic. The pandemic has additionally caused disruption to mental health services, leading to a...

What do people with intellectual disabilities, their family members and paid carers understand about psychotropic medication? A rapid review.

People with intellectual disabilities are more likely to be prescribed psychotropic medication than the general population and are frequently prescribed multiple medications. Understanding people with intellectual disabilities and carer perspectives is essential to improving the quality of psychotropic medication prescribing and usage. A rapid review explored people with intellectual disabilities' understanding of psychotropic medications, as well as family members and paid carers, and how this understanding can be improved. Twenty-one journal articles were included. Lack of understanding of medication was universal, with participants often unaware of adverse effects, alternatives, and rights around medication. There was also a lack of involvement in decision making for all participants. Some interventions aimed at people with intellectual disabilities or paid carers helped to improve knowledge. Evaluating how best to improve psychotropic medication understanding for people with intellectual disabilities, family members and paid carers should be a focus for future research.

Psychotropic Medication Prescription Patterns in Down Syndrome in a Large Pediatric Specialty Clinic.

Objectives: Patterns of psychotropic medication use in children and adolescents with Down syndrome (DS) are largely unknown. Clinical decisions are often made from evidence and experience from individuals with autism spectrum disorder (ASD) or intellectual disability (ID). Methods: Longitudinal data from 670 children with DS who received care in a specialty DS clinic from March 2021 to February 2024 were collected. After each clinic visit, the clinician indicated the presence or absence of co-occurring neurodevelopmental (ND) or mental health (MH) diagnoses, as well as whether the individual was prescribed a psychopharmacological treatment. We used descriptive statistics and analyzed associations between psychotropic medication use, co-occurring ND/MH conditions, and demographic data. Results: 19.1% of patients were prescribed at least one psychotropic medication at their most recent clinical visit. Alpha-agonists were the most commonly prescribed medication class (30.8%), followed by stimulants (18.9%), and antidepressants (16.7%). There was a significant difference in psychotropic medication use by age, with older children having increased odds of being prescribed a psychotropic medication. There were no differences in psychotropic medication use across sex (p = 0.10), race (p = 0.10), or household income (p = 0.16). Conclusions: We found that one-fifth of patients with DS were prescribed psychotropic medications. Nearly every individual with DS who was prescribed a psychotropic medication had a co-occurring ND/MH condition, yet these rates were lower than what have been reported in children with ID, ASD, and attention deficit/hyperactivity disorder. Further research needs to include those with DS to further understand medication efficacy and safe dosing practices to ensure optimal outcomes.

Generalized anxiety disorder screening scores are associated with greater treatment need among Veterans with depression

Comorbid anxiety and depression predict a poorer prognosis than either disorder occurring alone. It is unclear whether self-reported anxiety symptom scores identify patients with depression in need of more intensive mental health services. This study evaluated how anxiety symptoms predicted treatment receipt and outcomes among patients with new depression diagnoses in the Veterans Health Administration (VHA). Electronic medical record data from 128,917 VHA patients (71.6% assessed for anxiety, n = 92,237) with new diagnoses of depression were analyzed to examine how Generalized Anxiety Disorder-7 (GAD-7) scores predicted psychotropic medication prescriptions, psychotherapy receipt, acute care service utilization, and follow-up depression symptoms. Patients who reported severe symptoms of anxiety were significantly more likely to receive adequate acute phase and continuation phase antidepressant treatment, daytime anxiolytics/sedatives, nighttime sedative/hypnotics, and endorse more severe depression symptoms and suicidal ideation at follow-up. Patients who reported severe symptoms of anxiety at baseline were less likely to initiate psychotherapy. The GAD-7 may help identify depressed patients who have more severe disease burden and require additional mental health services.

RETOUR DEXPERIENCE CLINIQUE SUR TROIS ANS DE PRESCRIPTION DE LA FLUOXETINE EN PEDOPSYCHIATRIE UNIVERSITAIRE

Objectives: Our work has three objectives: To analyze our prescribing practices for fluoxetine in the light of international recommendations, to evaluate the tolerance and effectiveness of this molecule in children and adolescent and to identify the rules for proper use in this age group. Patients and method: We conducted a cross-sectional and descriptive clinical study spanning a period of 3 years, from January 2021 to January 2024, concerning children and adolescents aged between 8 and 17 years old who had been diagnosed with major depressive disorder, persistent depression, and/or anxiety disorders, or bulimia and placed on fluoxetine for a minimum follow-up period of 4 months and a maximum of 18 months. Results: The prescription of fluoxetine concerned 76 patients out of 660 patients with mood and anxiety disorder out of a total of 2215 patients. Major depressive disorder is the most common child psychiatric diagnosis (90%), anxiety disorders are present in 10%. Fluoxetine is prescribed as first-line treatment with psychotherapy in 40% of cases. Indicated as second-line treatment in 60% of patients due to an insufficient response or non-response to psychotherapy. No pre-therapeutic assessment is carried out. Fluoxetine is prescribed as monotherapy at an initial dose of 20 mg/day taken in the morning for an average duration of 9 months for depressive disorders and 12 to 18 months for anxiety disorders. Consented cessation of treatment is gradual. We report good therapeutic compliance and good tolerance with an average effectiveness time of 10 days. Mainly two side effects are described: headache and nervousness. We report one case of manic conversion in a 14years old girl. Discussion: The prescription of psychotropic medications in children and adolescents can only be considered as part of multimodal care, generally as second-line treatment when the adequate therapeutic response is not achieved or sometimes as first-line treatment when the clinical case is immediately severe or with there is an impact on the child and/or those around him. Only fluoxetine has label use in children aged over 8 years for moderate to severe depressive episodes. Fluoxetine is supported by the greatest results of evidence for its effectiveness and superiority compared to other SSRIs in this indication. Fluoxetine is also indicated in juvenile anxiety disorders and obsessive-compulsive disorder. Conclusion: In the case of mood and anxiety disorders in children, notably depression, fluoxetine is the choice molecule with the best tolerance-effectiveness ratio.

Adherence to Guidelines and Federal Psychotropic Medication Labels for the Treatment of Medicaid-Insured Children With ADHD.

This study examined adherence to clinical practice guidelines (CPGs) and U.S. Food and Drug Administration (FDA) medication labels when prescribing psychotropic medications to Medicaid-insured children with attention-deficit hyperactivity disorder (ADHD). A retrospective analysis was conducted with 2016-2018 Medicaid claims data across 46 states for children with an ADHD diagnosis and at least one psychotropic medication prescription (N=1,236,068 children). Medications recommended for pediatric use were identified with CPGs from the American Academy of Child and Adolescent Psychiatry and the Florida Medicaid Drug Therapy Management Program for Behavioral Health. Across 46 states, 86.7% of children received guideline-recommended and FDA-approved medications for the treatment of ADHD and comorbid mental disorders. Antidepressants, antihistamines, and second-generation antipsychotics that were not included in CPGs were prescribed for 23.4% of children. High adherence to CPGs and FDA medication labels for medications prescribed for ADHD was observed, suggesting the effectiveness of guidelines in driving evidence-based care.

Socio-demographic variation in diagnosis of and prescribing for common mental illnesses among children and young people during the COVID-19 pandemic: time series analysis of primary care electronic health records.

The impact of the COVID-19 pandemic on the mental health of children and young people (CYP) has been widely reported. Primary care electronic health records were utilised to examine trends in the diagnosing, recording and treating of these common mental disorders by ethnicity and social deprivation in Greater Manchester, England. Time-series analyses conducted using Greater Manchester Care Record (GMCR) data examined all diagnosed episodes of anxiety disorders and depression and prescribing of anxiolytics and antidepressants among patients aged 6-24 years. The 41-month observation period was split into three epochs: Pre-pandemic (1/2019-2/2020); Pandemic Phase 1 (3/2020-6/2021); Pandemic Phase 2 (7/2021-5/2022). Rate ratios for all CYP specific to sex, age, ethnicity, and neighbourhood-level Indices of Multiple Deprivation (IMD) quintile were modelled using negative binomial regression. Depression and anxiety disorder rates were highest in females, CYP aged 19-24, and White and 'Other' ethnic groups. During Pandemic Phase 1, rates for these diagnoses fell in all demographic subgroups and then rose to similar levels as those recorded pre-pandemic. In Pandemic Phase 2, rates in Black and Mixed-ethnicity females rose to a significantly greater degree (by 54% and 62%, respectively) than those in White females. Prescribing rates increased throughout the study period, with significantly greater rises observed in non-White females and males. The temporal trends were mostly homogeneous across deprivation quintiles. The observed fluctuations in frequency of recorded common mental illness diagnoses likely reflect service accessibility and patients' differential propensities to consult as well as changing levels of distress and psychopathology in the population. However, psychotropic medication prescribing increased throughout the observation period, possibly indicating a sustained decline in mental health among CYP, and also clinicians' responses to problems presented. The comparatively greater increases in frequencies of diagnosis recording and medication prescribing among ethnic minority groups warrants further investigation.

Nationwide burden of sudden cardiac death among patients with a psychiatric disorder

Abstract Background and aim Patients with psychiatric disorders have increased all-cause mortality compared to the general population. Previous research has shown that they have a 4-fold increased risk of sudden cardiac death (SCD) among the young. However, the risk across all age groups remains unknown. Purpose To investigate the incidence of SCD in patients with psychiatric disorders aged 18-90 years in the Danish population by systematically reviewing all deaths in one year. Methods We examined all deaths in Denmark among residents aged 18-90 years in 2010 by reviewing death certificates and autopsy reports. All deaths were categorized as non-SCD, or SCD, based on the available information. Psychiatric disorder was defined according to ICD-10 criteria, or by redemption of a prescription for psychotropic medication within one year prior to death. Results Out of 4.3 million residents in 2010 aged 18-90 years, we observed 45 703 deaths of which 6 002 were SCD. Overall, the incidence of SCD was 4.35 times (CI: 4.20-4.50, p-value <0.001) higher among patients with psychiatric disorders than in the general population and was age dependent (p-value <0.001). When adjusting for age, sex, and comorbidities, psychiatric disorders were independently associated with SCD, with a hazard ratio (HR) of 2.46 (2.33-2.60, p-value: <0.001), with highest SCD risk among patients suffering from schizophrenic disorders with a HR of 5.27 (4.23-6.56 p-value <0.001). Furthermore, patients with psychiatric disorders had an expected 10-year excess loss of life of which 13% was caused by SCD. Conclusion The rate of SCD in patients with psychiatric disorders was 4 times higher than in the general population. Having a psychiatric disorder is independently associated with SCD. Life-expectancy for an 18-year-old with a psychiatric disorder is projected to be 10-years shorter in comparison.Incidence rate of SCD by age groupExcess loss of life-years

Impact of COVID-19 pandemic on prescription of psychotropic medications in the Italian paediatric population during 2020

BackgroundThere is a global perception that psychotropic utilization in children and adolescents is increasing, especially with the onset of COVID-19 pandemic. Available literature data on paediatric psychotropic medication prescriptions in Italy are limited to one or few regions and not updated. The aim of this study was to provide updated data on psychotropic prescriptions referred to the whole Italian paediatric population, as overall and by subgroups of medications and to evaluate if the COVID-19 pandemic during 2020 had an impact on prescription rates.MethodsA descriptive study on psychotropic drug utilization in children and adolescents (< 18 years) resident in all Italian regions during 2020 was performed. Patients registered in the Pharmaceutical Prescriptions database with at least one prescription/dispensing of a psychotropic medication (antipsychotics-N05A), (antidepressants-N06A) and (psychostimulants-N06BA) during the study period were considered. The indicators used were the prescription rate (number of prescriptions per 1000 children) and prevalence of use (proportion of the paediatric population with at least one prescription in the relevant year).ResultsDuring the 2020 the prevalence of psychotropic drug use in the paediatric population was 0.3%, increased of 7.8% if compared to 2019. The same trend was observed for the prescription rate, which recorded an average of 28.2 per 1000 children with an increase of 11.6% if compared to previous year, representing the 0.6% of the overall drug use in this age group. The data showed a growing trend prescription by age, reaching the peak in adolescents aged 12–17 years old, with a prescription rate of 65 per 1000 children and a prevalence of 0.71%. Considering the subgroups of psychotropic medications, the highest prevalence of use was found for antipsychotic drugs, received by the 0.19% of the paediatric population during 2020.ConclusionsPsychotropic drug utilization in children and adolescents has grown during 2020 in Italy and worldwide, raising alarms from health care clinicians and patient advocates about the increase of burden of mental diseases in paediatric population during the COVID-19 pandemic. A more systematic monitoring of the use of psychotropic medications should be implemented in all countries for collecting relevant information about children and adolescents taking psychotropic drugs, in order to address the present and the future of the mental health of the paediatric population.

Neuropsychiatric Comorbidities and Psychotropic Medication Use in Medicare Beneficiaries With Dementia by Sex and Race.

Neuropsychiatric symptoms affect the majority of dementia patients. Past studies report high rates of potentially inappropriate prescribing of psychotropic medications in this population. We investigate differences in neuropsychiatric diagnoses and psychotropic medication prescribing in a local US cohort by sex and race. We utilize Medicare claims and prescription fill records in a cohort of 100% Medicare North and South Carolina beneficiaries ages 50 and above for the year 2017 with a dementia diagnosis. We identify dementia and quantify diagnosis of anxiety, depression and psychosis using validated coding algorithms. We search Medicare claims for antianxiety, antidepressant and antipsychotic medications to determine prescriptions filled. Anxiety and depression were diagnosed at higher rates in White patients; psychosis at higher rates in Black patients. (P < .001) Females were diagnosed with anxiety, depression and psychosis at higher rates than males (P < .001) and filled more antianxiety and antidepressant medications than males. (P < .001) Black and Other race patients filled more antipsychotic medications for anxiety, depression and psychosis than White patients. (P < .001) Antidepressants were prescribed at higher rates than antianxiety or antipsychotic medications across all patients and diagnoses. Of patients with no neuropsychiatric diagnosis, 11.4% were prescribed an antianxiety medication, 22.8% prescribed an antidepressant and 7.6% prescribed an antipsychotic. The high fill rate of antianxiety (benzodiazepine) medications in dementia patients, especially females is a concern. Patients are prescribed psychotropic medications at high rates. This practice may represent potentially inappropriate prescribing. Patient/caregiver education with innovative community outreach and care delivery models may help decrease medication use.

Psychotropic medication use and mortality in patients with acute myocardial infarction complicated by cardiogenic shock

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): The Danish Heart Foundation the Research Foundation of Odense University Hospital &amp; Rigshospitalet. Background The impact of pre-existing mental illness on mortality in patients with acute myocardial infarction complicated by cardiogenic shock (AMICS) remains unclear. Purpose This study aims to assess the relation between pharmacologically treated mental disorders at the time of AMICS admission with patient characteristics and mortality. A surrogate marker for mental illness was defined as having at least one reimbursed prescription for psychotropic medication (Anatomical Therapeutic Chemical (ATC) group and subgroups N05, N06) within one year prior to admission with AMICS. Patients were divided into three therapy categories: None, one ATC subgroup, or two or more ATC subgroups. One-year survivors were further stratified by therapy status one year before admission and one year after discharge. Mortality was assessed at 30 days (5 years for one-year survivors). Kaplan-Meier estimates and univariable and multivariable Cox proportional hazards models were used to assess mortality rates stratified by treatment group. Results Of the cohort, 425 patients (25%) received therapy with psychotropic medication within the previous year at the time of presentation with AMICS. Polypharmacy (two or more ATC N05, N06 subgroups) was identified in 132 patients (8%). In these patients, there was a higher prevalence of comorbidities and a greater proportion of females (42% vs. 21%, p&amp;lt;0.001), compared to no treatment. More patients in the polypharmacy group presented with chest pain (60% vs. 52%, p=0.031), they were less often triaged directly to an invasive center (55% vs. 70%, p&amp;lt;0.001), and 30-day mortality was higher (73% vs. 51%, p&amp;lt;0.001). Among the 712 one-year survivors, 121 (17%) were treated with one or more drugs within one year before and after their AMICS admission. 149 (21%) began receiving therapy in the year following their AMICS admission. 422 (59%) never received psychotropic medication. In an unadjusted Cox model, therapy with two or more drugs, compared to no therapy, was associated with higher 30-day mortality (hazard ratio (HR) 1.77, 95% confidence interval (CI) 1.43-2.19, p&amp;lt;0.001). This association remained significant in multivariable analysis (HR 1.66, 95%CI 1.22-2.26, p=0.001). Among one-year survivors, therapy with one or more drugs before and after AMICS was tied to an almost two-fold increase in five-year mortality (adjusted HR 1.95, 95%CI 1.23-3.10, p=0.004). Conclusions AMICS patients with pharmacologically treated mental illnesses were associated with higher mortality rates, as well as less favorable clinical profiles and treatment patterns. This increased risk remains evident among one-year survivors.

Psychotropic Medication Prescriptions for Home-Based Palliative Care Oncology Patients.

Psychotropic Medication Prescriptions for Home-Based Palliative Care Oncology Patients.

Psychotropic Medication Prescribing for Children and Adolescents After the Onset of the COVID-19 Pandemic

Numerous studies have provided evidence for the negative associations of the COVID-19 pandemic with mental health, but data on the use of psychotropic medication in children and adolescents after the onset of the COVID-19 pandemic are lacking. To assess the rates and trends of psychotropic medication prescribing before and over the 2 years after the onset of the COVID-19 pandemic in children and adolescents in France. This cross-sectional study used nationwide interrupted time-series analysis of outpatient drug dispensing data from the IQVIA X-ponent database. All 8 839 143 psychotropic medication prescriptions dispensed to children (6 to 11 years of age) and adolescents (12 to 17 years of age) between January 2016 and May 2022 in France were retrieved and analyzed. Onset of COVID-19 pandemic. Monthly rates of psychotropic medication prescriptions per 1000 children and adolescents were analyzed using a quasi-Poisson regression before and after the pandemic onset (March 2020), and percentage changes in rates and trends were assessed. After the pandemic onset, rate ratios (RRs) were calculated between estimated and expected monthly prescription rates. Analyses were stratified by psychotropic medication class (antipsychotic, anxiolytic, hypnotic and sedative, antidepressant, and psychostimulant) and age group (children, adolescents). In total, 8 839 143 psychotropic medication prescriptions were analyzed, 5 884 819 [66.6%] for adolescents and 2 954 324 [33.4%] for children. In January 2016, the estimated rate of monthly psychotropic medication prescriptions was 9.9 per 1000 children and adolescents, with the prepandemic rate increasing by 0.4% per month (95% CI, 0.3%-0.4%). In March 2020, the monthly prescription rate dropped by 11.5% (95% CI, -17.7% to -4.9%). During the 2 years following the pandemic onset, the trend changed significantly, and the prescription rate increased by 1.3% per month (95% CI, 1.2%-1.5%), reaching 16.1 per 1000 children and adolescents in May 2022. Monthly rates of psychotropic medication prescriptions exceeded the expected rates by 11% (RR, 1.11 [95% CI, 1.08-1.14]). Increases in prescribing trends were observed for all psychotropic medication classes after the pandemic onset but were substantial for anxiolytics, hypnotics and sedatives, and antidepressants. Prescription rates rose above those expected for all psychotropic medication classes except psychostimulants (RR, 1.12 [95% CI, 1.09-1.15] in adolescents and 1.06 [95% CI, 1.05-1.07] in children for antipsychotics; RR, 1.30 [95% CI, 1.25-1.35] in adolescents and 1.11 [95% CI, 1.09-1.12] in children for anxiolytics; RR, 2.50 [95% CI, 2.23-2.77] in adolescents and 1.40 [95% CI, 1.30-1.50] in children for hypnotics and sedatives; RR, 1.38 [95% CI, 1.29-1.47] in adolescents and 1.23 [95% CI, 1.20-1.25] in children for antidepressants; and RR, 0.97 [95% CI, 0.95-0.98] in adolescents and 1.02 [95% CI, 1.00-1.04] in children for psychostimulants). Changes were more pronounced among adolescents than children. These findings suggest that prescribing of psychotropic medications for children and adolescents in France significantly and persistently increased after the COVID-19 pandemic onset. Future research should identify underlying determinants to improve psychological trajectories in young people.

Reviewing the art of safe prescription practices: A checklist for the use of psychotropic drugs during pregnancy

Half of the women diagnosed with a mental health condition requiring regular medication have previously given birth to children. A dilemma arises when deciding whether to continue medication to treat the mother&amp;rsquo;s illness or potentially cease or replace medication in the interests of their child. This study endeavors to examine the challenges associated with prescribing psychotropic medications to pregnant women experiencing mental health disorders. Its primary objective is to furnish a checklist delineating essential considerations for prescribers in such cases. The investigation underscores the pivotal equilibrium required in addressing the mental health of the mother while mitigating risks to the developing fetus. The paper delves into the nuances of decision-making within this framework, highlighting the importance of a collaborative health-care approach coupled with personalized treatment strategies. These strategies may encompass modifications in medication regimens and the incorporation of non-pharmacological interventions. The prescription of psychotropic medications to pregnant women with mental health conditions presents complex challenges and demands consideration. Striking a critical balance is imperative, as it entails managing the mother&amp;rsquo;s mental health while minimizing potential risks to the developing fetus. The decision-making process is nuanced, influenced by factors such as the teratogenic potential of specific medications, the risk of neonatal withdrawal syndrome, and the potential for adverse outcomes in maternal and fetal health if psychiatric conditions remain untreated. Pre-conception counseling and maternal-fetal medicine services are beneficial tools in navigating this balance. Predictors of the necessity for medication during pregnancy include the patient&amp;rsquo;s diagnosis, severity of prior episodes, and responsiveness to treatment. The dynamic landscape of pharmaceutical research underscores the importance for prescribers to actively engage with evolving literature, ensuring the provision of accurate and up-to-date advice. Effective shared decision-making is of paramount significance in instilling confidence and assuring the patient.

Psychotropic medication prescribing in male juvenile justice facilities

This study examined medical files for former residents of six juvenile residential facilities. A review of medical files for 223 male, justice-involved adolescents revealed that 139 (62.33 %) received one or more psychotropic medications during at least one of their stays. Of the residents who received at least one medication (n = 139), prescribers most often prescribed antidepressants (74.8 %), antipsychotics (50.4 %), and stimulants (43.32 %). The authors assessed the predicting and maintaining variables that impacted psychotropic medication use as a treatment for adolescents with mental health concerns. Receiving medication prior to intake increased the likelihood of a resident receiving psychotropic medication. Additionally, older adolescents had a decreased likelihood of receiving psychotropic medication. Surprisingly, only risk score significantly impacted the continuation of medication at discharge. Overall, residents received less medication at discharge when compared to medication count at intake. Furthermore, additional comparisons between the residents in this study and those of Anderson et al. (2022) revealed no prescribing differences for residents who did or did not receive additional psychotherapeutic services.