National trends in concomitant psychotropic medication with stimulants in pediatric visits: Practice versus knowledge

Bhatara, Vinod S.; Feil, Michael; Hoagwood, Kimberly; Vitiello, Benedetto; Zima, Bonnie T.

doi:10.1177/108705470400700404

Cited by 45 publications

(32 citation statements)

References 40 publications

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“…35,36 Such use is known to be out of proportion with the evidence base for psychotropic medications in children. 37,38 The long-term effects of many off-label central nervous system medications in children have not been evaluated, and some studies suggest that more adverse drug reactions occur in pediatrics. 39,40 Given the limited evidence for safety and effectiveness of these medications, further evaluation of these drugs in children and efforts to examine the circumstances in which this prescribing occurs are needed.…”

Section: Discussionmentioning

confidence: 99%

Off-Label Prescribing to Children in the United States Outpatient Setting

Bazzano¹,

Mangione-Smith²,

Schonlau³

et al. 2009

Academic Pediatrics

127

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Section: Discussionmentioning

confidence: 99%

Off-Label Prescribing to Children in the United States Outpatient Setting

Bazzano¹,

Mangione-Smith²,

Schonlau³

et al. 2009

Academic Pediatrics

127

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“…The rate of combined antidepressant and stimulant use increased in the 1990s (Rushton and Whitmire, 2001 ;Bhatara et al 2004) up to 30.1 % of SSRI users in 1998(Rushton and Whitmire, 2001. Similarly, other studies report that 20-33 % of young people taking antidepressants also receive stimulants (Zito et al 2002 ;Hunkeler et al 2005).…”

Section: Most Common Combination Patterns Involving Antidepressantsmentioning

confidence: 97%

Polypharmacy with antidepressants in children and adolescents

Díaz‐Caneja

Espliego

Parellada

et al. 2012

Int. J. Neuropsychopharm.

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The aim of this study was to review current epidemiological data on the use of antidepressants in co-prescription with other psychotropic drugs in children and adolescents, as well as available efficacy and safety information. A Medline search from inception until February 2012 was performed to identify epidemiological and clinical studies, reviews and reports containing potentially relevant information on polypharmacy with antidepressants in young people. There has been an increase in polypharmacy in children and adolescents involving antidepressants in recent years. Antidepressants have become one of the drug classes most frequently prescribed in combination and are commonly co-prescribed with stimulants and antipsychotics. Most information regarding efficacy and safety of polypharmacy patterns was provided by case series and open-label studies. Efficacy studies gave some support for the use of a combination of antidepressants and antipsychotics in the management of refractory obsessive-compulsive disorder and some residual symptoms in major depressive disorder. Even less empirical support was found for a combination of stimulants and antidepressants in co-morbid attention deficit hyperactivity disorder and mood or anxiety disorders. Adverse events were similar to those found with individual medication groups, with severe adverse events mostly reported by individual case reports. The use of polypharmacy with antidepressants has become a regular practice in clinical settings. Although there is still little efficacy and safety information, preliminary evidence points to the potential clinical usefulness of some polypharmacy patterns. Further research on patients with co-morbidities or more severe conditions is needed, in order to improve knowledge of this issue.

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“…However, the fi eld is also seeing a two point fi ve -to eightfold increase in polypharmacy, or the practice of prescribing more than one medication to treat a disorder (Bhatara, Feil, Hoagwood, Vitiello, & Zima, 2004 ). Unfortunately, the research support for the use of polypharmacy with youth is scant and it is nonexistent regarding support for the use of more than two psychotropic medications concurrently (Safer, Zito, & dos Reis, 2003 ).…”

Section: Psychopharmacologymentioning

confidence: 99%

Clinical Health Psychology

2013

Encyclopedia of Sciences and Religions

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Mental and behavioural problems during childhood and adolescence are a serious publichealth concern. About half of all lifetime mental disorders begin before the age of 14 years. Worldwide prevalence rates for child and adolescent mental disorders are around 20% with similar types of disorders across cultures … the gap in mental -health services for children and adolescents with mental disorders is evident in virtually all countries at a time when the need has never been greater. (Belfer & Saxena, 2006 , p. 551) Clinical child psychology as a research and practice specialty of applied psychology seeks to investigate and remediate mental health problems for children, adolescents, and their families. Aspects of clinical child psychology are found in different countries with a broad range of populations, settings, problems, assessment, and intervention techniques. As noted in one defi nition,The research and practices of Clinical Child Psychology are focused on understanding, preventing, diagnosing, and treating psychological, cognitive, emotional, developmental, behavioral, and family problems of children. Of particular importance to clinical child and adolescent psychologists is a scientifi c understanding of the basic psychological needs of children and adolescents and how the family and other social contexts infl uence socioemotional adjustment, cognitive development, behavioral adaptation, and health status of children and adolescents. (Clinical Child Psychology Formal Specialty Defi nition, 2005 ) Several efforts and developments in the United States, as one example of formalizing the clinical child psychology specialty, include recognition as a specialty in professional

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National trends in concomitant psychotropic medication with stimulants in pediatric visits: Practice versus knowledge

Cited by 45 publications

References 40 publications

Off-Label Prescribing to Children in the United States Outpatient Setting

Off-Label Prescribing to Children in the United States Outpatient Setting

Polypharmacy with antidepressants in children and adolescents

Clinical Health Psychology

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