Psychotropic Medication Use Patterns in Children

Tanya Froehlich, MD, MS Associate Professor Division of Developmental and Behavioral Pediatrics Cincinnati Children's Hospital Medical Center 3333 Burnet Avenue, MLC 4002 Cincinnati, OH Interview with:
Tanya Froehlich, MD, MS
Associate Professor
Division of Developmental and Behavioral Pediatrics
Cincinnati Children’s Hospital Medical Center
3333 Burnet Avenue, MLC 4002
Cincinnati, OH  45229 What are the main findings of the study?

Dr. Froehlich: In a national sample of 2 to 5 year olds, the likelihood of psychotropic prescription peaked in the mid-2000s (at 1.5%), then stabilized in the late 2000s (to 1.0%). Increased psychotropic use in boys, white children, and those lacking private health insurance was documented. Were any of the findings unexpected?

Dr. Froehlich: We expected that rates of preschool psychotropic use would increase each year, and did not expect the stabilization of usage we observed in the late 2000’s.  This finding may be explained in part by public response to FDA warnings issued for psychotropic medications in the mid- to late-2000s, include black box warnings for suicide risk for the selective serotonin reuptake inhibitors and atomoxetine, and advisories regarding possible cardiovascular risk for stimulant medications. What should clinicians and patients take away from your report?

Dr. Froehlich: Our findings underscore the need to ensure that doctors of very young children who are diagnosing ADHD, the most common behavioral diagnosis in this study sample, and prescribing stimulants, the most commonly used psychotropic medications, are using the most up-to-date and stringent diagnostic criteria and clinical practice guidelines. What recommendations do you have for future research as a result of this study?

Dr. Froehlich: Given the continued use of psychotropic medications in very young children and concerns regarding their effects on the developing brain, future studies on the long-term effects of psychotropic medication use in this age group are essential.


National Trends in Psychotropic Medication Use in Young Children: 1994–2009

Vilawan Chirdkiatgumchai, Hong Xiao, Bridget K. Fredstrom,  Ryan E. Adams, Jeff N. Epstein, Samir S. Shah, William B. Brinkman, Robert S. Kahn, and Tanya E. Froehlich
Pediatrics peds.2013-1546; published ahead of print September 30, 2013, doi:10.1542/peds.2013-1546


Last Updated on October 4, 2013 by Marie Benz MD FAAD