Table 1.

Federal and other population-based surveys on pediatric psychotropic polypharmacy.

Data source, Study period, References	Age, years	Other	No. psychotropic concomitants	Point prevalence, denominator	Outcome
MEPS, 1999–2015 Zhang et al. (19)	0–17	3 periods, 1999–2015, parent reported, trends	≥3 classes	0–17 y/o with any psychotropic dispensing	In 2015, nearly 300,000 youth received ≥3 classes concomitantly, a doubling in 12 years
NAMCS/NAHMCS, 2003–2010 Burcu et al. (25)	6–19	Any behavioral diagnostic code (312–314) excluding serious conditions approved for antipsychotic use	Antipsychotic + 1 or ≥2 concomitant classes	6–19 y/o with any prescribed antipsychotic	85% with ADHD diagnosis; 1 concomitant + ATP = 50.7%; 2 concomitants + ATP = 39.1%
NAMCS, 2006–2015; NHAMCS, 2006–2011 Girand et al. (26)	2–24	ADHD diagnosed	≥2 ADHD medications alone; ≥2 ADHD medication + other psychotropics	2–24 y/o with any prescribed ADHD medication	≥2 ADHD meds: 16.8–20.5% ≥2 ADHD + other psychotropic classes: 26.0–40.7%
Community pharmacy-based parent survey Hilt et al. (27)	3–17	Is polypharmacy associated with more adverse drug events? N = 1,347 Parent reports of any psychotropic dispensing.	2 classes; ≥3 classes concomitantly	N = 1,348 youth w/ any psychotropic dispensing	Compared with montherapy: 2 classes had 17% increase in likelihood of *ADEs;≥3 classes had 38% increase in *ADEs
NAMCS, 1996–2007 Comer et al. (16)	6–17	Any prescribed psychotropics, trends	≥2 classes	6–17 y/o with any prescribed psychotropic	From 14.3 to 20.2% across 11 years
NAMCS, 1993–1998 Bhatari et al. (28)	0–17	Stimulant users, trends	Stimulant + ≥1 psychotropics	0–17 y/o with any prescribed psychotropic	2.9 to 6.9 to 14.7% of stimulant users had ≥1 other psychotropics

^*ADEs, Adverse Drug Events.