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Psychotropic medications are increasingly prescribed to children (see JW Psychiatry Apr 1 2000), leading to concerns about overuse. These authors developed an ADHD prescription safety program for children enrolled in fee-for-service Medicaid in Washington State.
The program required second-opinion consultations for prescriptions of stimulants and atomoxetine for ADHD that were above safety thresholds. These thresholds were high doses (e.g., dextroamphetamine >60 mg/day; methylphenidate or atomoxetine >120 mg/day), young age (children <5 years), or combination prescriptions for longer than 30 days. Preselected committees of community practitioners provided the second opinions.
The database included approximately 21,000 children taking medicati…