Polypharmacy in children and adolescents initiating antipsychotic drug in 2008–2016: a nationwide register study

Figures & data

Table 1. Characteristics of new antipsychotic users and those with polypharmacy between 2008 and 2016.

	Individuals with polypharmacy (N = 6660)		All individuals (N = 14849)
	N	Proportion (%)	N	Proportion (%)
Sex
Boys	2962	44.5	7598	51.2
Girls	3698	55.5	7251	48.8
Age group, years
1–6	172	2.6	622	4.2
Boys	145	84.3	502	80.7
Girls	27	15.7	120	19.3
7–12	1862	28.0	5125	34.5
Boys	1503	80.7	4027	78.6
Girls	359	19.3	1098	21.4
13–15	2645	39.7	5239	35.3
Boys	756	28.6	1801	34.4
Girls	1889	71.4	3438	65.6
16–17	1981	29.7	3863	26.0
Boys	558	28.2	1267	32.8
Girls	1423	71.8	2596	67.2
Frequency of polypharmacy (≥1 prescribed concurrent drug during AP treatment)
2008	640	9.6
2009	613	9.2
2010	635	9.5
2011	726	10.9
2012	743	11.2
2013	809	12.1
2014	778	11.7
2015	736	11.1
2016	980	14.7
Number of cotreatment drugs in new AP users
1	6384	95.9
2	215	3.2
3	58	0.9
4 or more	3	0.05
Drug prescribed concurrently with AP treatment
Antidepressants (N06A)	4603	66.2
Psychostimulants, agents used for ADHD and nootropics (N06B)	2143	30.8
Anxiolytics (N05B)	105	1.5
Antipsychotics (N05A)^a	55	0.8
Hypnotics and sedatives (N05C)	41	0.6
Psycholeptics and psychoanaleptics in combination (N06C)	1	0.1
Number of psychotropic drugs two years prior to AP treatment
1	4952	96.0
2	203	3.9
3	2	0.1
ATC groups of psychotrpic drugs two years prior to AP treatment
Antidepressants (N06A)	2908	54.2
Psychostimulants, agents used for ADHD and nootropics (N06B)	2267	42.3
Anxiolytics (N05B)	126	2.3
Hypnotics and sedatives (N05C)	56	1.0
Antiepileptics (N03A)	7	0.2

^a Antipsychotics other than risperidone, quetiapine, aripiprazole, and olanzapine.

Table 2. Frequency of concomitant psychotropic drugs during the first year of antipsychotic treatment in different age and sex groups.

Age group, years	Antidepressants (N06A)	Psychostimulants, agents used for ADHD and nootropics (N06B)	Anxiolytics (N05B)	Antipsychotics (N05A)	Hypnotics and sedatives (N05C)
1–6	*	160 (92.5)	*	0	*
Boys	*	140 (87.5)	*	0	0
Girls	*	20 (12.5)	*	0	*
7–12	441 (23.1)	1433 (75.1)	20 (1.1)	*	*
Boys	248 (56.2)	1270 (88.6)	13 (65.0)	*	*
Girls	193 (43.8)	163 (11.4)	7 (35.0)	*	*
13–15	2302 (82.7)	404 (14.5)	33 (1.2)	32 (1.2)	*
Boys	481 (20.9)	308 (76.2)	11 (33.3)	5 (15.6)	*
Girls	1821 (79.1)	96 (23.8)	22 (66.7)	27 (84.4)	*
16–17	1857 (89.0)	146 (7.0)	43 (2.1)	16 (0.8)	22 (1.0)
Boys	476 (25.6)	91 (62.3)	16 (37.2)	6 (37.5)	11 (50.0)
Girls	1381 (74.4)	55 (37.7)	27 (62.8)	10 (62.5)	11 (50.0)

Number (percentage). *The numbers less than 12 are not shown due to secrecy confidentiality reasons.

Figure 1. Univariate logistic regression model of predictors for psychotropic polypharmacy in Finnish children and adolescents (n = 14,849) who initiated antipsychotic treatment between 2008 and 2016. OR: odds ratio; CI: confidence interval. All variables analyzed separately (univariate) in a logistic regression model.

Figure 2. Adjusted logistic regression model of predictors for psychotropic polypharmacy in Finnish children and adolescents (n = 14 849) who initiated antipsychotic treatment between 2008 and 2016. OR: odds ratio; CI: confidence interval. All variables included in the same logistic regression model (adjusted).