TABLE 2a.

Pediatric psychotropic polypharmacy studies of publicly funded programs using medicaid analytic eXtract (MAX) data.

Data source, Study period, References	Age, years	Other	Psychotropic concomitants	Overlappingdays	Outcome
1999–2010, 29 states (MAX), Soria Saucedo et al. (29)	0–17	N = 692,485 with a psychotropic dispensing, 12 year trend,	≥2 within or Interclass	≥45	21.2% (1999) to 27.3% (2010) for any concomitants, within or interclass. 89% of concomitant use is interclass. ~200,000 youth with ≥2 concomitants in 2010.
2005, 4 large states (MAX), assesses impact of length of overlap re number and % of medicated youth Chen et al. (30)	6–18	N = 282,910 with a psychotropic dispensing	≥2 interclass	≥14 ≥30 ≥60	≥14 = 28.8% (81,478) ≥30 = 27.2% (76,951) ≥60 = 20.9% (59,128) Illustrates the impact of avoiding unintentional polypharmacy, i.e., switching.
2004–2008, 42 states (MAX), Kreider et al. (31)	6–18	N = 490,000 children; N = 540,000 adolescentscontinuous annual enrollees, with a psychotropic class & atypical antipsychotic, 5 year trend,	Inter-class Pairs w/antipsychotic	≥14	Pairs of concomitants: stimulant + ATP = 22.4%;ATD + ATP = 31.7%; mood stabilizer + ATP = 52.1%. Duration of concomitant pairs affected 69–89% of annual medicated days.