In Brief

Rates of psychotropic drug use for children and adolescents almost paralleled adult rates during the 1990s, shows an analysis of data from several health-care systems.

The study appeared in a recent issue of the Archives of Pediatrics and Adolescent Medicine (Vol. 157, No. 1).

A research team led by Julie Magno Zito, PhD, an associate professor of pharmacy and medicine at the University of Maryland, Baltimore, analyzed data from 1987 to 1996 on 900,000 patients. Some were from Medicaid programs in a midwestern state and a mid-Atlantic state. Others were from from a large, nonprofit, health-maintenance organization (HMO) in the Northwest.

The analysis revealed that, by 1996, the prevalence of psychotropic medication use among patients younger than 20 years old was between 5.9 percent and 6.3 percent--a three-fold increase since 1987 for the patients from the HMO and the Midwestern state and a doubling of the previous rate for the mid-Atlantic youths. Stimulants were the most commonly prescribed drugs in both health-care systems. Antidepressants ranked second. The results also showed a proportional increase in female patients receiving stimulants and male patients taking antidepressants, particularly in the 10- to 14-year-old age group.

According to the study, the rates of psychotropic drug use in Medicaid patients almost always exceeded the rates in the HMO group. Rates of use of antidepressants and hypnotics were similar for both groups. Lead researcher Zito says more comprehensive data must be compiled on regional versus nationwide drug-prevalence rates, as well as on drug safety and the effects of long-term treatment.

"You can't just assume children are little adults," she says. "We have to make sure this is the right medicine for the right person at the right time."

Also warranting more attention is the effectiveness and necessity of psychotropic treatments for children, Zito says. "We have to do more work to compare the drugs against non-pharmacological interventions first," she says.