“Medications are important,” said Dr. Stephanie Kienbeck, a pediatric emergency physician at Cincinnati Children’s Hospital, who has studied treatment approaches for suicidal impulses. It is also vital, she said, “to know that medicine has its limits. Therapy is the cornerstone of what we try to get kids into.”
Polypharmacy became more common following 2013, when the clinical definition of ADHD was updated and expanded. Previously, the Diagnostic and Statistical Manual of Mental Disorders, the standard reference for diagnosing thousands of medical conditions, stated that an ADHD diagnosis is applied if a patient exhibits “certain symptoms of hyperactivity-impulsivity or inattention that have caused a deficiency”.
In 2013, the vulnerability condition was removed, among other changes that together have “significantly increased diagnostics,” according to an analysis by Journal of the American Medical Association. From 2015 to 2016, 13.1% of teens aged 12 to 17 were diagnosed with ADHD, according to a diary analysis.
Cases of polypharmacy don’t always start with an ADHD diagnosis Last summer, 22-year-old Jane, whose middle name is known to protect her privacy, grew increasingly restless and depressed ahead of her final year of university.
In April of this year, she was taking seven psychotropic drugs. They included lamotrigine, an antiepileptic drug used for mood. Hydroxyzine, gabapentin and propranolol for anxiety. escitalopram, an antidepressant. Mirtazapine for the treatment of major depressive disorder. and lithium carbonate, for general mood disorders, although it is also used to treat bipolar disorder, which Jeanne has not been diagnosed with.
Later that month, Jane confided in a group counseling session that she thought she might be suicidal. She was then prescribed three other drugs, including quetiapine, an antipsychotic used to treat schizophrenia, among other disorders.
