Patterns in the use of psychotropic medication for treatment of 900,000 youths ages 2 to 19 were assessed from the time period 1987-1996 using patient prescription data from Medicaid services and a health maintenance organization (Zito et al., 2003). The total psychotropic medication prevalence for youth increased by 200 to 300 percent during that period of time and included most classes of medication. There was a 4- to 10-fold increase for antidepressants and a 3- to 7-fold increase for stimulants. The 1996 prevalence rate for psychotropic medication in youth ranged from 5.9 to 6.3 percent, with stimulants and antidepressants ranked first and second. The authors concluded that the utilization of psychotropic medication by youth during the 1990s nearly reached adult utilization rates.

The prevalence of the use of psychotropic medications among youths in 1999-2000 ranged from 3.5 to 4.5 percent in the age group 0 to 17. This information was obtained from youth enrolled in a children’s insurance program in the mid-Atlantic states (Safer, Zito, and Gardner, 2004).

An estimate of the use of psychotropic medication by 559,769 youth with psychiatric diagnoses in the U.S. Mental Health Service System was conducted in 1997 (Warner, Pottick, and Muckherjee, 2004). Estimates of medication use among youth ages 6 to 12 and ages 13 to 17 were similar (33 and 34 percent, respectively). Boys had significantly higher rates of medication use than girls (35 compared with 28 percent). The diagnoses and percentage treated with medication were as follows: psychotic disorders (66 percent), attention deficit hyperactivity disorder (52 percent), mood disorder (45 percent), anxiety disorder (32 percent), conduct disorder (28 percent), personality disorders (23 percent), developmental and pervasive disorders (20 percent), and adjustment disorder (15.5 percent). Overall, 32.5 percent of youth in the mental health service system were treated with a psychotropic medication.

A retrospective study to assess antidepressant utilization was conducted using outpatient prescription and clinical service records of youths ages 2 to 19 and enrolled in Medicaid and health maintenance organizations during 1988-1999 (Zito et al., 2002). It was found that there was a 3-to 5-fold increase in the prevalence of antidepressant treatment of youth who were younger than 20 years old. The prevalence rate for antidepressant use in youth was 0.6 percent in 1988 and 1.9 percent in 1994. Attention deficit hyperactivity disorder, followed by depression, was the most common diagnosis associated with antidepressant use.

The prevalence rate of the use of antidepressants for youths younger than age 18 was assessed using nationwide data of ambulatory prescription claims for the years 1998-2002 (Delate et al., 2004). The overall prevalence of antidepressant use among children increased from 1.6 percent in 1998 to 2.4 percent in 2002, for an annual adjusted increase of 9.2 percent.

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