Annual trends in psychotropic drug prescription in American minors, 1996-2018

Background: Pharmacoepidemiological studies suggest that psychotropic drug prescription to US minors has increased as much as ten-fold since the 1980's. However, few have estimated nationally representative prescription trends in all psychotropic classes annually and across multiple decades. Methods: The Medical Expenditure Panel Survey (MEPS) tracks Americans' use of healthcare, including prescribed medicines. Here, annual MEPS data from 1996 to 2018 (n=23) were used to estimate overall and class-specific prevalence of psychotropic prescription per 100 minors aged 2 to 17 (inclusive), and to identify factors associated with any psychotropic use. Results: Psychotropic prescription to US minors rose from 3.5% (95% CI = 2.9%, 4.1%) in 1996 to 7.6% (95% CI = 6.7%, 8.5%) in 2018, with increases largely driven by increased use of the stimulant and antidepressant classes, and increased psychotropic prescription to girls and young women; Hispanic minors; and adolescents. Odds of psychotropic prescription in adolescents nearly doubled from 1996 (OR=8.8, 95% CI = 4.0, 19.4) to 2018 (OR=15.4, 95% CI = 9.6, 24.8)