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Extensive Atypical Antipsychotic Use in Medicaid-Insured Youth

ADHD-diagnosed foster care youth have increased odds of atypical antipsychotic use

Extensive Atypical Antipsychotic Use in Medicaid-Insured Youth

WEDNESDAY, April 16, 2014 (HealthDay News) -- Medicaid-insured youth, particularly those in foster care and those diagnosed with attention-deficit/hyperactivity disorder (ADHD), have considerable exposure to atypical antipsychotics, according to a study published in the April issue of the Journal of Child and Adolescent Psychopharmacology.

Mehmet Burcu, from the University of Maryland in Baltimore, and colleagues characterized the duration of atypical antipsychotic use by age group and Medicaid eligibility category. Data were collected for 266,590 youth, aged 2- to 17-years-old, who were enrolled in a mid-Atlantic state Medicaid program in 2006.

The researchers found that atypical antipsychotics were typically used for a median of 180 days. Duration of use was longer for children (2 to 12 years; median, 192 days) than for adolescents (13 to 17 years; median, 179 days). For foster care youth diagnosed with ADHD, without any comorbid psychiatric diagnosis, the odds of atypical antipsychotic use were more than three-fold higher than for youth enrolled in income-eligible Medicaid categories. Regardless of age group, nearly one-third of ADHD-diagnosed foster care youth received atypical antipsychotics, with a median annual duration of use of more than 250 days for 2- to 12-year-olds. The most common concomitant atypical antipsychotic regimens were risperidone, aripiprazole, and quetiapine.

"Exposure to atypical antipsychotics in Medicaid-insured youth, in particular for children in foster care and those diagnosed with ADHD, was substantial, warranting outcomes research for long-term effectiveness, safety, and oversight for appropriate cardiometabolic monitoring," the authors write.

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