Side effects from use of one or more psychiatric medications in a population-based sample of children and adolescents

Robert J. Hilt, Monica Chaudhari, Janice F Bell, Christine Wolf, Kent Koprowicz, Bryan H. King

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objective: The purpose of this study was to investigate the side effect risks from using one or more psychiatric medications (including antipsychotics, antidepressants, α-2 agonists, benzodiazepines, mood stabilizers, and stimulants) among a national cohort of children and adolescents. Methods: A questionnaire survey was administered to parents who filled a prescription for a psychiatric medication for their child at a large national retail pharmacy chain. Primary outcome variables were the total count of side effects from a list of 12 problem areas, as well as parent-reported side effect intensity (mild/moderate/severe). Modifiers investigated included specific medication and number of medications utilized, demographics, and difficulties with access to care. Results: A total of 1347 parents of study subjects ages 3-17 years from 30 U.S. states who were taking psychiatric medications for any indication purchased at one retail pharmacy chain enrolled following a single mail invitation (7.5% response). Of the study subjects, 80% were white/non-Hispanic, 64% were male, 63% had private health insurance, and 67% had used a current medication for >1year. Most (84%) had one or more parent-reported side effect. After adjusting for covariates, subjects with two medications reported 17% (p<0.001) and with three or more medications reported 38% (p=0.002) increases in their average number of side effects than did children taking one medication. Parental reporting of difficulties in accessing care also predicted a 42% (p<0.001) greater number of side effects than for those who had no access difficulties. Side effects were particularly more common in medication combinations including either selective serotonin reuptake inhibitors (SSRIs) (77% higher odds, p<0.001) or antipsychotics (99% higher odds, p<0.001). Conclusions: Side effects from psychiatric medications appear to be both more common and more severe overall with increasing numbers of medications utilized, and with perceived difficulty in accessing care. Polypharmacy regimens including either SSRIs or antipsychotics were especially associated with experiencing side effects, within this study sample.

Original languageEnglish (US)
Pages (from-to)83-89
Number of pages7
JournalJournal of Child and Adolescent Psychopharmacology
Volume24
Issue number2
DOIs
StatePublished - Mar 1 2014

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Psychiatry
Antipsychotic Agents
Serotonin Uptake Inhibitors
Population
Parents
Polypharmacy
Postal Service
Health Insurance
Benzodiazepines
Antidepressive Agents
Prescriptions
Demography

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pediatrics, Perinatology, and Child Health
  • Psychiatry and Mental health

Cite this

Side effects from use of one or more psychiatric medications in a population-based sample of children and adolescents. / Hilt, Robert J.; Chaudhari, Monica; Bell, Janice F; Wolf, Christine; Koprowicz, Kent; King, Bryan H.

In: Journal of Child and Adolescent Psychopharmacology, Vol. 24, No. 2, 01.03.2014, p. 83-89.

Research output: Contribution to journalArticle

Hilt, Robert J. ; Chaudhari, Monica ; Bell, Janice F ; Wolf, Christine ; Koprowicz, Kent ; King, Bryan H. / Side effects from use of one or more psychiatric medications in a population-based sample of children and adolescents. In: Journal of Child and Adolescent Psychopharmacology. 2014 ; Vol. 24, No. 2. pp. 83-89.
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abstract = "Objective: The purpose of this study was to investigate the side effect risks from using one or more psychiatric medications (including antipsychotics, antidepressants, α-2 agonists, benzodiazepines, mood stabilizers, and stimulants) among a national cohort of children and adolescents. Methods: A questionnaire survey was administered to parents who filled a prescription for a psychiatric medication for their child at a large national retail pharmacy chain. Primary outcome variables were the total count of side effects from a list of 12 problem areas, as well as parent-reported side effect intensity (mild/moderate/severe). Modifiers investigated included specific medication and number of medications utilized, demographics, and difficulties with access to care. Results: A total of 1347 parents of study subjects ages 3-17 years from 30 U.S. states who were taking psychiatric medications for any indication purchased at one retail pharmacy chain enrolled following a single mail invitation (7.5{\%} response). Of the study subjects, 80{\%} were white/non-Hispanic, 64{\%} were male, 63{\%} had private health insurance, and 67{\%} had used a current medication for >1year. Most (84{\%}) had one or more parent-reported side effect. After adjusting for covariates, subjects with two medications reported 17{\%} (p<0.001) and with three or more medications reported 38{\%} (p=0.002) increases in their average number of side effects than did children taking one medication. Parental reporting of difficulties in accessing care also predicted a 42{\%} (p<0.001) greater number of side effects than for those who had no access difficulties. Side effects were particularly more common in medication combinations including either selective serotonin reuptake inhibitors (SSRIs) (77{\%} higher odds, p<0.001) or antipsychotics (99{\%} higher odds, p<0.001). Conclusions: Side effects from psychiatric medications appear to be both more common and more severe overall with increasing numbers of medications utilized, and with perceived difficulty in accessing care. Polypharmacy regimens including either SSRIs or antipsychotics were especially associated with experiencing side effects, within this study sample.",
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