4F-03 - National Trends in Psychotropic Medication Use, Psychotropic Polypharmacy, and Potential Drug-Drug Interactions Among US Children, Adolescents, and Young Adults

Background: Mental health issues are a significant public health concern among the young, and psychotropic medications can play an important role in managing psychiatric conditions. However, the concomitant use of multiple psychotropic medications, referred to as psychotropic polypharmacy, and the concurrent use of psychotropic medications with other non-psychotropic drugs, may increase the risk of adverse outcomes from drug-drug interactions (DDIs). Despite these concerns, existing evidence in this area provides limited insights into real-world utilization patterns.

Objectives: To assess the prevalence of psychotropic medication use and polypharmacy, investigate indications for use, and evaluate the prevalence of exposure to potential DDIs among United States (US) residents aged 6–24 years.

Methods: We conducted a repeated-measures cross-sectional study using nationally representative data from the US National Health and Nutrition Examination Survey collected between 2001 and 2020. The study population included individuals aged 6–24 years with at least one prescription for a psychotropic medication, including a stimulant, antidepressant, antipsychotic, benzodiazepine-related drug, or mood stabilizer. Participants were stratified into three age groups: children (6–11 years), adolescents (12–19 years), and young adults (20–24 years). We assessed trends in the use of psychotropic medications and psychotropic polypharmacy (≥ 3 medications) using linear regression models. The reported indications were analyzed by age group. We used Micromedex to identify potential DDIs among individuals using psychotropic medications in combination with other drugs.

Results: Psychotropic medication use among individuals aged 6–24 years increased from 2001 to 2020, with a weighted prevalence rising from 5.5% to 8.8% (average percentage point change: 2.8%; 95% confidence interval: 1.9%–3.8%; p = 0.001). A similar increase was observed for psychotropic polypharmacy, with prevalence rising from 0.4% to 1.3% among the overall young population. The distribution of commonly reported indications varied across age groups. Among psychotropic medication users, 26.7% took drugs considered to constitute contraindicated or major potential DDIs according to the Micromedex report. Notably, most of these interactions involved antidepressants, and potential DDIs were particularly prevalent among adolescents.

Conclusions: Over the past two decades, an increasing trend in psychotropic medication use and psychotropic polypharmacy has occurred among young people. Notably, more than a quarter of psychotropic medication users face potential DDI risks, highlighting the urgent need for real-world evidence to assess the health impacts of these DDIs in younger persons.