Pharmacoepidemiology of Psychotropic Medications in Youth

Large community-based, computerized administrative datasets comprised of enrollment data, socio-demographic characteristics, and diagnostic and treatment information on all individuals in populations or a health insurance plan constitute the major resource for pharmacoepidemiologic research. Investigators use such data to estimate prevalence or new-onset medication use in terms of trends, persistence of use, and the demographic and clinical correlates of treatment. Physician visit data provide diagnoses which can be linked to medication use. This review covers psychotropic medication treatment patterns of U.S. youth over the last 20 years and reveals information very different from the findings derived from clinical trials or case series reports. Pharmacoepidemiologic data are more generalizable to the population at large. Recent trends show that concomitant psychotropic medication regimens, commonly including antipsychotics, have profoundly increased in youth, reflecting substantial off-label usage. Such population-based research can be used to identify and expand the public health mission in pediatric pharmacotherapy.