The use of psychiatric medications to treat mental health and behavioral disorders in children and young adults has risen over the past 20 years – including the prescribing of more than one medication at once. This is putting roughly 1 in 4 young people who take psychiatric medicines at risk of serious drug interactions, a new study out of the University of Pennsylvania found.
Overall use of psychiatric medications, including antidepressants, antipsychotics, stimulants for attention-deficit/hyperactivity disorder and benzodiazepines, increased from 5% in 2001 to 8% between in 2020 among people ages 6 to 34, the study found. At the same time, the prescribing of more than one medication rose from 1.8% to 3.3%.
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Prescribing multiple medications at once can make it difficult to distinguish between a child’s behavioral symptoms and the side effects of the drugs. Additionally, the simultaneous use of multiple psychotropic drugs can compound adverse side effects, such as fatigue or sedation, and put people at risk of abnormal heart rhythms and other serious medical issues, the researchers wrote.
“While these medicines can be helpful, our research highlights the need for careful monitoring when multiple medications are used, more research on long-term safety, and better access to non-drug treatments like therapy,” said senior author Sean Hennessy, a Penn professor of epidemiology, systems pharmacology and translational therapeutics. “Families should have open dialogue with their clinicians to help weigh the benefits and risks of these prescriptions and ensure regular follow-up to keep treatment safe and effective.”
The study used data from a nationally-representative group of people ages 6 to 24. The data was collected between 2001 and 2020 as part of the U.S. National Health and Nutrition Examination Survey.
During that period, the greatest increase in the prescription of psychiatric medication was seen among children and young adults, especially the use of stimulants, which rose from 2.7% to 5.4%. The most common combinations of medications were antidepressants and antipsychotics.
About half of the people taking antipsychotics for bipolar disorder, schizophrenia or other mental health issues also were also taking another medication – a combination that put them at risk of serious drug interactions, the researchers found.
Decreasing the risk of adverse drug effects from taking multiple medications at once requires intensive monitoring from a health care provider. The “complexity of real-world care” – which often leads to patients switching providers, for instance – may partly explain why some children are on dangerous drug combinations, said the study’s lead author, Lin-Chieh Meng, a Penn doctoral student in epidemiology.
While these dangers exist, the perception that young people are being overprescribed psychiatric medications is a myth, a 2018 study out of Columbia University Irving Medical Center found.
About 1 in 8 teenagers in the United States have a depressive episode each year, and about 1 in 12 children have symptoms of ADHD. At the same time, fewer than 1 in 30 teenagers were prescribed an antidepressant and 1 in 20 children were prescribed ADHD medication, according to that study.