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Many Kids Getting Multiple Psychiatric Medications

But researchers say side effects, interactions largely unknown

TUESDAY, Aug. 2, 2005 (HealthDay News) -- Pediatric polypharmacy -- prescribing two or more drugs to treat psychiatric symptoms in children -- is becoming more common in the United States.

The trend is raising worries about potential unknown side effects, according to a study in the August issue of Psychiatry 2005.

"This is a critical issue -- it's not uncommon to find a child on an antidepressant, 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," study co-author Dr. Joseph Penn, a child psychologist with the Bradley Hasbro Children's Research Center (BHCRC) in Providence, R.I., and Brown Medical School, said in a prepared statement.

He and his colleagues analyzed articles written over a 10-year period about pediatric polypharmacy. The articles showed that this practice is increasing in the United States, even though there are few scientific studies that can be used to justify it.

The study found the most frequent combination included stimulants such as Ritalin, Dexedrine and Adderall -- commonly used to treat attention-deficit/hyperactivity disorder -- used along with other psychotropic medication.

Penn and his colleagues also wrote that the prevalence of off-label prescriptions is another factor that increases the risks of prescribing multiple drugs to treat psychiatric symptoms in children.

"For example, atypicals 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," study co-author Dr. Henrietta Leonard, a child psychiatrist at BHCRC and Brown, said in a prepared statement.

"We just don't have the efficacy or safety data to back up what is common clinical practice," Leonard said.

"The FDA recently questioned whether there is a link between the use of antidepressants in children and suicidal thoughts -- if there is so much concern over the effects of a single drug, how much riskier is it to prescribe multiple drugs?" Penn questioned.

"We need more systematic studies to establish the safety and efficacy of medications in the pediatric age group," he said.

More information

The American Academy of Child and Adolescent Psychiatry has more about psychiatric medications for children and teens.

SOURCE: Lifespan, news release, Aug. 1, 2005
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