Psychotropic drug prescriptions for teenagers has skyrocketed

Psychotropic drug prescriptions for teenagers skyrocketed 250 percent between 1994 and 2001, rising particularly sharply after 1999, when the federal government allowed direct-to-consumer advertising and looser promotion of off-label use of prescription drugs, according to a new Brandeis University study in the journal Psychiatric Services.

This dramatic increase in adolescent visits to health care professionals which resulted in a prescription for a psychotropic drug occurred despite the fact that few psychotropic drugs, typically prescribed for ADHD, depression and other mood disorders, are approved for use in children under 18. The study is one of the first to focus on prescriptions to adolescents, rather than children in general.

The study shows that by 2001, one in every ten of all office visits by teenage boys led to a prescription for a psychotropic drug. Other findings in the study show that a diagnosis of ADHD was given in about one-third of office visits during the study period. Also, between 14 and 26 percent of visits in which psychotropic medications were prescribed did not have an associated mental health diagnosis, said lead author Professor Cindy Parks Thomas, an expert on prescription drug trends, at Brandeis University's Heller School for Social Policy and Management.

"There is an alarming increase in prescribing these drugs to teens, and the reasons for this trend need further scrutiny," said Thomas. "Our study suggests a number of factors may be particularly important to assess, including the impact of direct-to-consumer advertising and other marketing strategies."

Additional factors likely fueling the trend, noted by the authors, include greater acceptance among physicians and the public of psychotropic drugs, the advent of new medications with fewer side effects, increased screening for mental health disorders, and patient demand for such drugs. Nevertheless, the study noted that overall, pharmaceutical companies increased their spending on television advertising six fold, to $1.5 billion, between 1996 and 2000, with the trend accelerating after 1997, when the Food and Drug Administration Modernization Act was passed.

However, at the same time teenagers were being prescribed more psychotropic drugs than ever before, other prescription drugs taken by adolescents were trending down, said Thomas. For example, the use of antibiotics, the most widely prescribed drugs for teenagers, fell dramatically in response to widespread public educational campaigns about the dangers of antibiotic resistance due to overuse of these drugs.

"The dramatic increase in prescribing of psychotropic medications is of considerable concern, particularly because these medications are not without risks," Thomas said.

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