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Patterns of Psychotropic Medication Use in Very Young Children with Attention-Deficit Hyperactivity Disorder

RAPPLEY, MARSHA D. M.D.; ENELI, IHUOMA U. M.D.; MULLAN, PATRICIA B. Ph.D.; ALVAREZ, FRANCISCO J. M.D.; WANG, JENNY M.S.; LUO, ZHEHUI M.S.; GARDINER, JOSEPH C. Ph.D.

Journal of Developmental & Behavioral Pediatrics: February 2002 - Volume 23 - Issue 1 - p 23-30
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ABSTRACT. Psychotropic medications are increasingly used for very young children. Patterns of use in a well-described group of children 3 years and younger with a diagnostic label of attention-deficit hyperactivity disorder (ADHD) reveal both reasons to use such medications and concerns about how these medications are used. Of 223 children with ADHD, more than half (n = 127) received psychotropic medications in an idiosyncratic manner, both in the specific medication and in use over time. Almost half of the children who were medicated did not have opportunities for monitoring as often as every 3 months, despite the fact that more than half received psychotropic medications for 6 months or longer. Children with comorbid mental health conditions and chronic health conditions were at greater risk for receiving psychotropic medications. These patterns of use demonstrate a compelling need for guidance in psychopharmacological treatment of very young children.

Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University

Office of Medical Education Research and Development, College of Human Medicine, Michigan State University

Department of Internal Medicine/Pediatrics, University of Southern California, Los Angeles, California

Department of Epidemiology, College of Human Medicine, Michigan State University

Departments of Statistics and Epidemiology, College of Human Medicine, Michigan State University, East Lansing, Michigan

Address for reprints: Marsha D. Rappley, M.D., Michigan State University, College of Human Medicine, Department of Pediatrics and Human Development, B220 Clinical Center, 138 Service Road, East Lansing, MI 48824; e-mail: rappley@msu.edu; fax: 517-355-8312.

Presented in part as a poster at the Pediatric Academic Societies’ Annual Meeting, San Francisco, California, May 1–4, 1999.

© 2002 Lippincott Williams & Wilkins, Inc.