Author ORCID Identifier

https://orcid.org/0000-0002-5809-8309

Date of Award

5-31-2026

Document Type

Open Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Counseling

First Advisor

Lisa Cosgrove

Second Advisor

Boaz Levy

Abstract

Youth in the U.S. and internationally are increasingly being diagnosed with depression and related psychiatric conditions (Murthy, 2021) many of whom are being subjected to non-evidence-based, or what has been termed irrational, psychotropic polypharmacy (Barnett & Concepcion Zayas, 2019). Psychotropic polypharmacy can be defined as “the use of 2 or more psychiatric medications in the same patient,” (Zito et al., 2021) though definitions can vary. Using data from the Center for Health Information Analysis’ Massachusetts All-Payer Claims Database, this study examined the sociodemographic factors associated with high rates of polypharmacy, a hypothesized increase in pediatric psychotropic polypharmacy rates in Massachusetts during the COVID-19 pandemic compared to the rates before the pandemic, and the classes of psychotropic medications being prescribed concurrently at the highest rates from 2018-2022. The findings revealed the main sociodemographic factors that were associated with higher rates of polypharmacy were being a male and having an older age, an increase of pediatric psychotropic polypharmacy rates in Massachusetts from 2018-2022, and the classes of psychotropic medications being prescribed concurrently at the highest rates from 2018-2022 as stimulants,  “other” psychotropic medications (which included Clonidine Hydrochloride, Guanfacine, Propranolol Hydrochloride, Prazosin Hydrochloride), anti-anxiety medications, antidepressants, mood stabilizers, antipsychotics, and hypnotics. The contributions from this study underscore the need for state-level monitoring systems, deprescribing initiatives, and trauma-informed, non-pharmacologic interventions to ensure more equitable care for children and adolescents.

Comments

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