New Study Warns About Rising Numbers of Teens Being Prescribed Multiple Psychiatric Drugs At Same Time

More teens and children are taking multiple psychiatric drugs at the same time than in previous years, as diagnoses for disorders like depression and ADHD increase nationwide, which could lead to unpredictable outcomes, according to a group of Maryland researchers.

The safety of taking multiple psychiatric drugs at the same time, also known as polypharmacy, has not been well studied in children and teens, and little is known about the  impact developing brains. Yet, the rate of polypharmacy among children and teens increased by nearly 10% from 2015 to 2020, according to the findings of a study published on February 16 in the journal JAMA Network Open.

Researchers from the University of Maryland School of Pharmacy conducted a cross-sectional study including nearly 127,000 teens in one U.S. state. Researchers declined to say which state, but said that the data provides a representation of children and teens across the country.

The data focused on psychiatric polypharmacy trends from 2015 to 2020 among teens ages 17 years and younger enrolled in Medicaid. Researchers tracked pharmacy claims for psychiatric medication among four groups: low-income teens, teens enrolled in the Children’s Health Program (CHP), teens in foster care, and teens with disabilities.

Youth Polypharmacy Rates Increasing

Overall, the findings indicate there was a 9.5% increase in the prevalence of children and teens taking three or more psychiatric medications at the same time.

Teens taking multiple psychiatric medications, such as antipsychotics, mood stabilizers, anticonvulsants, antidepressants, and medication for attention deficit hyperactivity disorder (ADHD), increased at least 4% every year from 2015 to 2020. The rate of polypharmacy among children and teens in foster care also increased from 10.8% in 2015 to 11.3% by 2020.

Teens in the Children’s Health Program also were more likely to be using three or more psychiatric medications in 2020, compared to 2015. Overall, the rate increased from 2.2% in 2015, to 2.8% in 2020. Among low-income youth, the rate increased from 2.1% to 2.8% by 2020, the data indicates.

The use of multiple psychiatric drugs was nearly four times more likely among teens who are disabled and was three times as likely for teens in foster care compared to low-income teens.

Teens ages 10 to 14 had nearly twice the odds of using three or more psychiatric medications, and teens 15 to 17 had 2.5 times the risk of using three or more medications than those younger than 10 years old.

Similarly, Black, Asian, Latino, American Indian, and Pacific Islander teens had lower odds of using multiple psychiatric medications compared to white teens.

Youth Drug Combinations Should Be Monitored

The rates of polypharmacy are increasing together with rising rates of children diagnosed with conditions like ADHD and depression, which often result in the prescription of psychiatric medications, such as Prozac and Adderall, the researchers warned.

In some cases, the drugs are being used off-label in young people. In other cases, the medications are simply being prescribed together, and it is unclear how simultaneous use can affect children’s health and brain development.

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

Doctors are being urged to closely monitor teens who are using multiple psychiatric drugs, especially those in foster care and those with disabilities, who may be at risk or need more support.