Antipsychotics were most commonly prescribed to youth 19 years and younger for an off-label use – disruptive behavioral disorders.

More info: Authors evaluated outpatient prescription insurance claims for Texas Medicaid antipsychotics between January 1, 1998, and December 31, 2001 for youth 19 years and younger. Of these claims, 35% of use was off-label for disruptive behavioral disorders; ADHD being most common example of this disorder, followed by oppositional defiant disorder, conduct disorder and impulse control disorder. Depressive disorders, also off-label, were the...

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Medicaid’s cost for ADHD drugs rose dramatically in the past decade, mostly driven by off-label use of antipsychotics for ADHD in youth.

More info: The authors examined a large, state Medicaid database between 1996 and 2005to determine spending on medications for 107,486 children (3 to 17 years old) diagnosed with ADHD . Spending on stimulant medications increased 157% during this period due to increases in the price of prescriptions; during this time, there was a 588% increase in antipsychotic spending due to large increases in price and quantity used. From the...

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Over two thirds of off-label antipsychotic prescriptions in children are for uses where there is only uncertain evidence of efficacy.

More info: The authors used physician survey data from IMS Health NDTI, a representative sample of data collection of office visits from 4,800 physicians between 1996-2008. The number of treatment visits among children that included an antipsychotic prescription increased eight-fold from 1995 to 2005 with off-label use with uncertain evidence increasing to 67%. From the source: Use of antipsychotic agents in youth younger than 18...

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Over 40% of medicated foster children were receiving polypharmacy of 3 or more psychotropic drugs.

More info: During one month in 2004, authors examined Medicaid data from a random sample of 472 medicated youth in foster care aged 0 through 19 years in a southwestern US state. Of the foster children who had been given psychotropic medication, 41.3% received > or = 3 different classes of these drugs and 15.9% received > or = 4 different classes. The most frequently used medications were antipsychotic agents (53.2%)...

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There has been a significant increase in the percentage of children receiving polypharmacy.

More info: Researchers examined records of 27,979 doctor’s visits by children aged 6 to 17 years recorded in the National Ambulatory Medical Care Surveys in 1996–2007, of which 3466 visits involved a psychotropic prescription. Youth visits for psychotropic-medication increased from 14% to 20% during this 12-year period. The most frequent diagnoses for polypharmacy visits were for disruptive disorders (54%) and mood disorders...

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Antipsychotic polypharmacy is common in youth in Medicaid, despite there being little evidence supporting this practice in children with severe emotional disturbances.

More info: Investigators evaluated 5 years of Medicaid data (July 2002 to June 2007), looking at antipsychotic polypharmacy in children (6 to 12 years old) and adolescents (13 to 17 years) enrolled in Florida’s Medicaid fee-for-service program. Antipsychotic polypharmacy was defined as the receipt of 2 > antipsychotic medications at the same time for more than 60 days. During the 5 year period, 12,764 children and 10,419 adolescents...

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