“Medication is important,” said Dr. Stephanie Kennebeck, a pediatric emergency room physician at Cincinnati Children’s Hospital who has studied therapeutic approaches for suicidal impulses. It was also vital, she said, “to know that medication has its limitations. Therapy is the cornerstone of what we try to get kids involved with.”
Polypharmacy became even more common after 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 a diagnosis of ADHD applied if the patient had “some hyperactive-impulsive or inattentive symptoms that caused impairment ”.
In 2013, the disability requirement was dropped, among other changes that together “led to a significant increase in diagnosis,” according to an analysis in The Journal of the American Medical Association. Between 2015 and 2016, 13.1 percent of teens ages 12 to 17 were diagnosed with ADHD, according to the journal’s analysis.
Cases of polypharmacy don’t always start with an ADHD diagnosis Last summer, Jean, 22, who goes by her middle name to protect her privacy, grew increasingly agitated and depressed before her senior year at college.
By April of this year, he was taking seven psychiatric medications. They included lamotrigine, an antiepileptic drug used for mood; hydroxyzine, gabapentin, and propranolol for anxiety; escitalopram, an antidepressant; mirtazapine to treat major depressive disorder; and lithium carbonate, for general mood disorders, although it is also used to treat bipolar disorder, which Jean has not been diagnosed with.
Later that month, Jean confided in a counseling group that she thought she might be suicidal. Subsequently, he was prescribed three more medications, including quetiapine, an antipsychotic used to treat schizophrenia, among other disorders.