Psychoactive medication prescribing practices for U.S. Children: Gaps between research and clinical practice

Peter S. Jensen, Vinod S. Bhatara, Benedetto Vitiello, Kimberly Hoagwood, Michael Feil, Laurie B. Burke

Research output: Contribution to journalArticle

212 Scopus citations

Abstract

Objective: To determine national pediatric prescribing practices for psychotropic agents and to examine these practices in view of the available evidence concerning their safety and efficacy in this age group. Method: Prescribing data from 2 national databases based on surveys of office-based medical practices were determined and reviewed vis-a-vis available safety and efficacy evidence: Results: Data indicate that levels of psychotropic prescribing in children and adolescents are greatest for stimulants, resulting in nearly 2 million office visits and 6 million drug 'mentions' in 1995. Selective serotonin reuptake inhibitors were the second most prescribed psychotropic agents, while anticonvulsant mood stabilizers (prescribed for a psychiatric reason), tricyclic antidepressants, central adrenergic agonists, antipsychotics, benzodiazepines, and lithium were also prescribed for a substantial number of office visits. Comparison of prescribing frequencies with available safety and efficacy data indicates significant gaps in knowledge for commonly used agents. Conclusions: Most psychotropic agents require further sustained study to ensure appropriate health care expenditures and vouchsafe children's safety. Recommendations for researchers, parents federal agencies and industry are offered as a means to accelerate the pace of research progress.

Original languageEnglish (US)
Pages (from-to)557-565
Number of pages9
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume38
Issue number5
DOIs
StatePublished - Jan 1 1999

Keywords

  • Childhood mental disorders
  • Medication safety and efficacy
  • Pharmacoepidemiology
  • Prescribing practices
  • Psychopharmacology

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

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