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.
