Researchers used pharmacy and enrollment data from six health plans to study usage patterns of the four drug classes used to treat attention deficit hyperactivity disorder and depression in youth-central nervous system stimulants, selective serotonin reuptake inhibitors, tricyclic antidepressants, and other antidepressants. Researchers examined trends in physician prescribing practices of psychotropics but did not focus on the appropriateness of prescribing patterns or quality-of-care models.

In analysis of usage patterns of central nervous system stimulants, data showed that the proportion of patients treated with methylphenidate (Ritalin) declined, whereas the proportion treated with a mixed product of dextroamphetamine and amphetamine salts (Adderall) increased. Among all patients under 20 years of age, the proportion prescribed both a stimulant and a selective serotonin reuptake inhibitor almost doubled, from 1.4 per 1,000 to 2.6 per 1,000 over the 5-year evaluation period.

A child's initial prescription for a stimulant was written by a pediatrician in 50 percent of cases and by a family practice physician in 20 percent of cases. In contrast, the initial prescription for a reuptake inhibitor was written most often by a psychiatrist, although the actual proportion decreased from 56 to 44 percent over the study period.

The use of antidepressants other than selective serotonin reuptake inhibitors and tricyclic antidepressants increased by 195 percent.

Researchers noted that these results confirm previously published research on the use of stimulants and antidepressants among American children and adolescents.