Study finds more young people taking multiple psychiatric drugs

An increasing number of children and adolescents are prescribed multiple psychiatric drugs to take simultaneously, according to a new study in the state of Maryland. The phenomenon is increasing despite warnings that combinations of psychotropic medications have not been tested for safety in young people or their impact on the developing brain studied.

The study, published Friday in JAMA Open Network, looked at prescribing patterns among patients ages 17 and younger enrolled in Medicaid in Maryland from 2015 to 2020. In this group, there was a 9.5 percent increase in the prevalence of “polypharmacy,” which the study defined as taking three or more different classes of psychiatric medications, including antidepressants, mood-stabilizing anticonvulsants, sedatives, and ADHD and anti-anxiety medications.

The study analyzed only one state, but state data They have been used in the past to explore this topic, in part because of the relative ease of collecting data from Medicaid, the state-administered health insurance program.

At the same time, some research using nationally weighted samples has revealed the increasing prevalence of polypharmacy among young people. A recent article drew data from the National Ambulatory Health Care Survey and found that in 2015, 40.7 percent of people ages 2 to 24 in the United States who took one ADHD medication also took a second psychiatric drug. That figure had increased from 26 percent in 2006.

The most recent data from Maryland show that, at least in one state, the practice continues to grow and “was significantly more likely among youth with disabilities or in foster care,” the new study noted.

Mental health experts said psychotropic medications can be very helpful and that doctors have discretion to prescribe what they deem appropriate. A concern among some experts is that many drugs used in frequently prescribed cocktails have not been approved for use in young people. And it is unclear how the simultaneous use of multiple psychotropic medications affects brain development in the long term.

The latest study analyzed data from 126,972 people during the study period. It found that in 2015, 4.2 percent of Medicaid enrollees under age 17 in Maryland had overlapping prescriptions for three or more different classes of psychiatric medications. That figure increased to 4.6 percent in 2020.

The numbers were higher for those in foster care, where the prevalence of polypharmacy increased from 10.8 percent to 11.3 percent.

“The findings emphasize the importance of monitoring the use of psychotropic combinations, particularly among vulnerable populations, such as youth enrolled in Medicaid who have a disability or are in foster care,” the study concluded.