Managing mental health conditions such as depression, anxiety, attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD) can be challenging, especially for teenagers who are beginning to exhibit adult-like decision-making skills and behaviors but still have developing brains, hormones, and other life factors.
Many doctors prescribe powerful psychiatric medications to help teens manage their anxiety quickly, but concern is quickly growing regarding this practice. Experts fear that rather than taking the time to find the root cause of a teenager’s anxiety, prescribing adolescents psychiatric drugs may instead be serving to not only hide the true cause for concern but making the problem worse. Unfortunately, prescription medications can result in serious adverse effects for the teen in question.10
Teenagers have a great deal going on in their lives, and as they enter adulthood, they’ll be required to strike an even more precarious balance between mental health, school, work, family, and more. While even adults struggle with the effects of psychotropic medications, with their developing brains, teens and mental health medications can be a risky mix. Instead, a holistic approach to treating mental health conditions may be more effective at helping teens manage their symptoms without relying on pharmaceuticals.
What Is Psychotropic Polypharmacy?
Polypharmacy in any context involves using more than one medication at a time, while psychotropic refers to any medication that alters someone’s mental state. Psychotropic polypharmacy, then, is the practice of prescribing multiple medications at a time to treat psychiatric conditions. Psychotropic polypharmacy can exist in an attempt to arrive at a successful treatment for a single condition or arise when people have multiple mental health conditions coupled with drug-induced symptoms, and receive multiple prescriptions in an attempt to combat them all.
Psychotropic polypharmacy has been on the rise as people seek avenues to deal with various mental health conditions. While polypharmacy is often thought of as an elderly person’s problem, as these individuals are likely to be exposed to multiple medications for multiple conditions that come with age, adolescents are at increased risk, with approximately 19% of adolescents in a national sample taking more than one psychotropic medication.1
This is true not only in the US, but in other countries as well. For example, just over one million people in Australia were prescribed at least one mental health medication from 2021 to 2022. Roughly 15 percent of people prescribed psychotropic medications were under the age of 18.2 In the United Kingdom, the number of prescriptions for certain psychotropic drugs increased by approximately 3 million in each of the last few years.3
Some of these prescriptions came from general practitioners, however, not qualified mental health professionals. While general practitioners are legally allowed to prescribe medications, many psychotropic drugs cannot reach their full potential for weeks and require frequent check-ins with a mental health professional.
However, according to the American Academy of Child & Adolescent Psychiatry (AACAP), there are just over 74 million children in the U.S. under 18 years old, but only just over 10,000 child and adolescent psychiatrists (CAPs). This would result in only 14 CAPs per 100,000 children. This demonstrates how very few children can actually have access to a CAP who could diagnose conditions and find the best solution for each.4
Because there are few mental health professionals (or none in some areas), teens may instead be given psychiatric medications to manage their condition. While symptoms may be alleviated for some, this doesn’t target the root problem itself.
How Does Polypharmacy Affect Teens?
Today’s teens may receive prescriptions for many psychotropic medications, especially selective serotonin reuptake inhibitors (SSRIs) prescribed for depression and related disorders and central nervous system stimulants like Ritalin and other drugs to treat ADD and ADHD. These psychotropic medications exert an effect on the brain by artificially manipulating levels of important brain chemicals known as neurotransmitters. These neurotransmitters are responsible for relaying chemical signals that balance the brain’s pleasure and reward systems, among many others.
Unfortunately, disrupting neurotransmitters may have the opposite effect as what the prescribing physician intended, worsening mental health symptoms. Worse, if one psychotropic doesn’t work for an individual, practitioners may rush to switch or combine medications, which can lead to some significant physical and mental health complications in anyone – but especially in teens.
It’s important to note that many common psychotropic medications originated as remedies for other issues but are prescribed off-label for use in addressing depression, anxiety, and other mental health issues. Not only were these medications never intended for use as antidepressants or antianxiety medications, but they were also developed with adults in mind. Adolescent brains are still developing, which means they do not function as mini-adults, but as the adolescents they are.
The combination of several strong medications at once can result in many negative consequences in adolescents, which may include:
Drowsiness
Insomnia
Weight gain
Kidney damage
Nausea
Mood swings and mood disorders
Suicidal thoughts
When taken long term, multiple psychotropic medications can cause the above symptoms as well as lasting symptoms like brain fog, brain zaps, fatigue, tardive dyskinesia (repetitive, involuntary movements), and more.
Worse, psychotropic polypharmacy can lead to these other negative effects 5:
Worsening side effects
Cumulative chemical toxicity
Diminished effectiveness of individual medications
Increased potential for medication errors by patients and providers
Adverse medication interactions
Potential over- and under-dosing of each medication
Mismanagement of drug-induced reactions
Patient noncompliance and abrupt disuse of the medications, causing further risks
In a story published on August 27, 2022, 6 The New York Times highlighted a teenager named Renae Smith, who was found to be taking ten different psychotropic medications to manage her depression and anxiety. The quest for a solution had begun in the fourth grade, when her family began looking for treatment options for her mental health condition, later diagnosed as ADHD.
By 2021, she was on several different medications that were designed to target mental health conditions. These included Prozac, Focalin, Topamax, Rexulti, and more. Despite these attempts to address her mental health condition – and likely because of the complex mix of psychotropic medications in her system at once – Renae continued to struggle with her depression.
Unfortunately, this is what her practitioners were trained to do, as they didn’t have any specific training for helping those with mental health conditions. However, the disruption in brain chemistry caused by the medications served to mask the true issue.
In April of 2022, Renae had a cancerous tumor in her thyroid removed. While her story shows the negative effects of psychotropic polypharmacy, Smith’s surgery was a success for both her physical and mental health. She credited the surgery as a way to begin self-reflection and reduce the number of medications she was taking. She also found a new psychiatrist who could meet with her on a regular basis and who was willing to explore alternatives for psychotropics.
How Did We Get Here?
The thought of a growing teenager taking ten medications for a mental health condition may sound shocking, but as studies confirm,, the practice is becoming more and more common.11 Renae Smith was prescribed several different medications for her ADHD and depression, but there was never an effort on the part of the medical community to identify the source of her depression symptoms. For example, when she was in eighth grade, she mentioned to her school’s guidance counselor that her family was struggling with finances, and she feared she wouldn’t be able to get into a large university. However, rather than target the root of the problem with coping skills, therapies, and holistic wellness practices like art and movement therapies, physicians prescribed medications.
The rise of psychotropic polypharmacy is concerning because it requires physicians and parents to subscribe to some common myths regarding children and pharmaceuticals. The first is that children are simply smaller adults and can effectively take a reduced dose of a medication to achieve the same results. The second is similar in that it involves the assumption that mental health concerns exist the same way among adults as they do in children.
Others assume that children experiencing mental health symptoms inevitably have a chemical imbalance that must be fixed, as they have no real reason to feel depressed or anxious. Finally, prescribers and parents often believe that medications are a quicker, more effective route to treating mental health symptoms. Unfortunately, all these assumptions are unsubstantiated and can ultimately lead to teens being prescribed multiple medications at once as providers attempt to land on a quick and easy solution.7
15 Years Experience by Professionals Who Understand Your Journey.
It’s essential for all healthcare providers and parents to know that children can indeed develop mental health symptoms like anxiety and depression at any age. As mentioned, some people believe these are conditions that only occur in late adolescence or adulthood because children have no real reason to feel unhappy, but this isn’t true. According to research, nearly half of all teens have experienced anxiety, depression, or another mental illness at some point in their lives.8
Rather than dismiss a teen’s claims that they’re feeling unwell mentally, it is crucial to understand that their experiences are valid. It is just as important to address these symptoms with proven techniques that will not serve to further disrupt the delicate neurotransmitter balance so crucial to human development. Fortunately, there are effective, non-drug-based treatment options available.
Counseling and Therapy
As mentioned, an important component of mental health care is working with a therapist to challenge negative thoughts. With counseling and therapy, teens can learn why they think the way they do. By being specific about what triggers anxiety or depression, teens and counselors can work together to tackle those factors head-on, so teens can learn to manage their condition. This is a process that can last a significant amount of time, but therapy can be well worth the effort.
Depending on the teen’s needs, a counselor may suggest:
Family therapy
Behavioral therapy
Cognitive behavioral therapy
Dialectical behavior therapy
Trauma therapy
And more.
Other Holistic Treatments
Along with discussing anxiety triggers, depressive thoughts, and other key elements with a counselor, teens can benefit from other holistic therapies as well. These therapies can help teens and counselors identify and address the root of the issue, provide a welcome outlet for anxiety or stress, build positive coping skills for triggering situations, and even develop lasting and fulfilling hobbies.
Methods that may be used in conjunction with traditional therapies include:
Physical exercises like yoga and qigong
Art therapy
Nutrition adjustments
Mindfulness exercises
Acupuncture
Massage
Spa therapies
Neurotransmitter therapy
Equine therapy
Neurotoxin removal
Peer support and group therapy,
And more
Using more natural healing methods can enable teens to manage mental health by keeping the body and mind in better shape. All the bodily systems work together, and a holistic approach can ensure all the potential causes of mental health symptoms are addressed, rather than relying on medications to treat their effects.
It’s common for adolescents to feel misunderstood or unlike everyone else around them. However, prescribing adolescents psychiatric drugs is often ineffective in helping them manage their internal struggles. Unfortunately, in many cases, the overprescription of multiple psychotropic drugs can actually worsen mental health. Increasing the number of medications in the system can result in drastic physical and mental health changes.
Fortunately, there is hope outside of the constant influx of psychotropic drugs. At Alternative to Meds Center, we are committed to providing education and holistic mental health treatment, treating persons aged 18 and over, who have felt unsatisfied, or worse, after using these medications. Please contact our knowledgeable staff for enrolment criteria and any other information that may be of interest to you.
1. Comer, J. S., Olfson, M., & Mojtabai, R. (2010). National trends in child and adolescent psychotropic polypharmacy in office-based practice, 1996-2007. Journal of the American Academy of Child & Adolescent Psychiatry, 49(10), 1001-1010. https://doi.org/10.1016/j.jaac.2010.07.007
3. Rabeea, S. A., Merchant, H. A., Khan, M. U., Kow, C. S., & Hasan, S. S. (2021). Surging trends in prescriptions and costs of antidepressants in England amid COVID-19. DARU Journal of Pharmaceutical Sciences, 29, 217-221.https://link.springer.com/article/10.1007/s40199-021-00390-z
5. Kukreja, S., Kalra, G., Shah, N., & Shrivastava, A. (2013). Polypharmacy in psychiatry: a review. Mens sana monographs, 11(1), 82–99. https://doi.org/10.4103/0973-1229.104497
7. Lakhan, S. E., & Hagger-Johnson, G. E. (2007). The impact of prescribed psychotropics on youth. Clinical practice and epidemiology in mental health : CP & EMH, 3, 21. https://doi.org/10.1186/1745-0179-3-21
This content has been reviewed and approved by a licensed physician.
Dr. Samuel Lee
Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente. He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.
Lyle Murphy is the founder of the Alternative to Meds Center, a licensed residential program that helps people overcome dependence on psychiatric medication and addiction issues using holistic and psychotherapeutic methods.
Medical Disclaimer: Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.
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