Sound Off on Psych MedsAdvocating for prudent medication use

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

Investigators evaluated antipsychotic polypharmacy for children (6 to 12 years old) and adolescents (13 to 17 years) enrolled in Florida’s Medicaid fee-for-service program from July 2002 to June 2007. During this 5 year period, 12,764 children and 10,419 adolescents received antipsychotic medication with 7% of children (881) and 8% (834) of adolescents receiving multiple antipsychotic medications. Antipsychotic polypharmacy was defined as the receipt of 2 or more antipsychotics medications at the same time for more than 60 days.

From the source:

“Children and adolescents who are treated with a single antipsychotic agent are at greater risk than adults for experiencing adverse events such as extrapyramidal symptoms, elevated prolactin concentrations, sedation, significant weight gain, elevated triglyceride concentrations, and insulin resistance. This greater risk appears to be exacerbated by polypharmacy. In Florida’s evidence-based guidelines for the treatment of children with severe emotional disturbances, antipsychotic polypharmacy is not recommended at any level for the treatment of any disorder.”

Tags:

Antipsychotic medication, Polypharmacy, Medicaid, Children’s mental health

Citation:

Constantine RJ, Boaz T, Tandon R. Antipsychotic polypharmacy in the treatment of children and adolescents in the fee-for-service component of a large state medicaid programClin Ther. 2010;32(5):949-959.