Sultan Ryan S, Correll Christoph U, Schoenbaum Michael, King Marrisa, Walkup John T, Olfson Mark
1 Department of Psychiatry, College of Physicians and Surgeons, New York State Psychiatric Institute, Columbia University , New York, New York.
2 Department of Psychiatry, The Zucker Hillside Hospital , Northwell Health, Glenn Oaks, New York.
J Child Adolesc Psychopharmacol. 2018 Apr;28(3):158-165. doi: 10.1089/cap.2017.0077. Epub 2018 Jan 29.
To describe national annual prescribing patterns of stimulant, antidepressant, and antipsychotic medications to young people.
Prescriptions for three commonly prescribed psychotropic classes (stimulants, antidepressants, and antipsychotics) to young people aged 3-24 years were analyzed from the IMS LifeLink LRx National Longitudinal Prescription database (n = 6,351,482). Denominators were adjusted to generalize estimates to the U.S.
Comparisons are presented of percentages filling ≥1 prescription of each medication class during the study year stratified by patient sex, age, and prescriber specialty.
The total annual percentage of prescriptions filled by youth for any of the three medication classes was by age 3-5 years (0.8%), 6-12 years (5.4%), 13-18 years (7.7%), and 19-24 years (6.0%). Stimulant use was highest for older children (age 11 = 5.7%). Antidepressant use tended to increase with age and was highest for young adults (age 24 = 4.8%). Annual antipsychotic prescription percentages were lower than antidepressant or stimulant percentages for all age groups, with a peak in adolescence (age 16 = 1.3%). Annual stimulant and antipsychotic percentages for males were higher than corresponding percentages for females, but converged for young adults. Psychiatrists and child psychiatrists accounted for most of the prescriptions of antidepressants (22.2%-53.2%) and antipsychotics (51.7%-70%), but fewer of the stimulant prescriptions (30.4%-36.2%).
The age and sex distribution of stimulants and antidepressants among young people is broadly consistent with known epidemiologic patterns of their established indications for attention-deficit/hyperactivity disorder, anxiety, and depression. The pattern of antipsychotics may reflect the heterogeneity of disorders and conditions treated with this medication class.
描述向年轻人开具兴奋剂、抗抑郁药和抗精神病药物的全国年度处方模式。
从IMS LifeLink LRx全国纵向处方数据库(n = 6,351,482)中分析了向3至24岁年轻人开具的三种常用精神药物类别(兴奋剂、抗抑郁药和抗精神病药)的处方。分母进行了调整,以便将估计值推广到美国人口。
按患者性别、年龄和开处方医生专业分层,比较了在研究年度内每种药物类别开具≥1张处方的百分比。
这三种药物类别中任何一种的年轻人年度处方总百分比在3至5岁为(0.8%),6至12岁为(5.4%),13至18岁为(7.7%),19至24岁为(6.0%)。年龄较大的儿童(11岁 = 5.7%)使用兴奋剂的比例最高。抗抑郁药的使用倾向于随年龄增加,在年轻人中最高(24岁 = 4.8%)。所有年龄组的年度抗精神病药物处方百分比均低于抗抑郁药或兴奋剂百分比,在青春期达到峰值(16岁 = 1.3%)。男性的年度兴奋剂和抗精神病药物百分比高于女性的相应百分比,但在年轻人中趋于一致。精神科医生和儿童精神科医生开具的抗抑郁药(22.2% - 53.2%)和抗精神病药(51.7% - 70%)处方占大多数,但兴奋剂处方较少(30.4% - 36.2%)。
年轻人中兴奋剂和抗抑郁药的年龄和性别分布与已知的注意力缺陷/多动障碍、焦虑症和抑郁症既定适应症的流行病学模式大致一致。抗精神病药物的模式可能反映了该药物类别所治疗疾病和病症的异质性。