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Polypharmacy in children on the rise in the US

Providence, RI Pediatric polypharmacy, the practice of prescribing two or more medications for psychiatric symptoms in children, is on the rise in the United States, raising concern about unknown side effects, according to a new study appearing in the August issue of the journal Psychiatry 2005.

"This is a critical issue - it's not uncommon to find a child on an anti-depressant, a mood stabilizer, and a sleep agent all at the same time, but there's no research to see how these drugs interact with each other" says co-author Joseph Penn, MD a child psychiatrist with the Bradley Hasbro Children's Research Center (BHCRC) in Providence, RI and Brown Medical School.

The authors reviewed 10 years of scholarly articles pertaining to polypharmacy in pediatric settings, and found that all the studies comparing these rates across time showed an increase in the practice.

However, the authors warn there are almost no studies or published research on which to justify prescribing multiple medications for psychiatric disorders in children.

According to the study, the most frequent combination were stimulants such as methylphenidate (Ritalin) or dextroamphetamine (Dexedrine, Adderall) commonly used to treat ADHD, with another psychotropic medication.

Another contributing factor to the increased risks of prescribing multiple drugs is the prevalence of off-label prescriptions the practice of prescribing a medication to children when there is not a FDA approved indication for that disorder in children.

"For example, aytpicals like risperidone are sometimes used to symptomatically treat psychosis or aggression in children, but most of these medications don't have FDA approval for use on psychiatric symptoms in the pediatric age group," says co-author Henrietta Leonard, MD, a child psychiatrist with the Bradley Hasbro Children's Research Center and Brown Medical School. "We just don't have the efficacy or safety data to back up what is
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Contact: Carol Hoy
choy@lifespan.org
401-432-1328
Lifespan
1-Aug-2005


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