PREVALENCE AND PATTERNS OF PSYCHOTROPIC AND ANTICONVULSANT MEDICATIONUSE IN CHILDREN AND ADOLESCENTS REFERRED TO RESIDENTIAL-TREATMENT

The prevalence and patterns of use of psychiatric and anticonvulsant m edications were studied in 83 seriously emotionally disturbed children and adolescents at the time of their admission to a residential treat ment facility. Youths (aged 5-19, mean = 13.6 years), consecutively ad mitted over 17 months, were assessed for the prevalence and patterns o f use of psychotropic and anticonvulsant treatments. At admission, 76% of the youths were receiving psychiatric pharmacotherapy, 40% with mo re than one psychiatric agent, and 15% with a combination of psychotro pic and anticonvulsant medications. Frequently prescribed medications were neuroleptics (35% of the medicated youths), sedative-hypnotics (2 6%), and anticonvulsants (15%). Psychostimulants (16%) and antidepress ants (22%) were under-prescribed relative to their diagnostic indicati ons. Over 50 different medication combinations were used. The neurolep tic + lithium combination was most common (25% of the polypharmacologi cal treatments). Neuroleptics were the most commonly prescribed medica tion and mostly used for nonpsychotic, nontic, and nonbipolar indicati ons (55% of neuroleptic trials). Neuroleptics were used primarily for aggression regardless of diagnosis. Neuroleptics were used more in sym ptomatic treatments than in treatments for indicated diagnoses. The hi gh prevalence of psychiatric and antiepileptic medication use in child ren and adolescents admitted to a residential treatment facility, and especially the pattern of their use, raises questions about prescribin g practices for youths entering residential treatment and about pediat ric psychopharmacotherapy in general.