SIGHTINGS



US Toddlers Being Drugged
With Prozac & Ritalin
At Soaring Rates
MSNBC News Services
http://www.msnbc.com/news/373292.asp
2-23-00
 

The number of preschoolers in the United States being prescribed antidepressants and stimulants soared in the mid-1990s, despite limited knowledge about the effects of such drugs on young children, according to a study published Tuesday.
 
The number of 2- to 4-year-olds on psychiatric drugs including Ritalin and anti-depressants like Prozac soared 50 percent between 1991 and 1995.
 
 
When he was a toddler, Heath Barker was nicknamed "the red tornado for his auburn hair and his penchant for tearing things up and jumping off the furniture. When he was just 4, he was diagnosed with attention deficit disorder and prescribed Ritalin.
 
A study of more than 200,000 preschool-age children shows this was no isolated case.
 
The number of 2- to 4-year-olds on psychiatric drugs including Ritalin and antidepressants like Prozac jumped 50 percent between 1991 and 1995, researchers reported in the Journal of the American Medical Association.
 
UNKNOWN EFFECTS
 
Experts said they are troubled by the findings because the effects of such drugs in children so young are largely unknown. Some doctors worry that such powerful drugs could be dangerous for children,s development.
 
"Unresolved questions involve the long-term safety of psychotropic medications, particularly in light of earlier ages of initiation and longer durations of treatment, the report said.
 
"While it is reassuring that anecdotal reports have rarely documented these problems, the possibility of adverse effects on the developing brain cannot be ruled out, it added.
 
The reasons for prescribing such medications in young children include pain relief, anxiety associated with medical, pre-surgery and dental procedures, bed wetting and attention-deficit/hyperactivity disorder in kids 3 years and older.
 
Although the study did not examine reasons for the increases, Julie Magno Zito, the lead author and an assistant professor of pharmacy and medicine at the University of Maryland, suggested a few possibilities.
 
With an increasing number of children attending day care, parents may feel pressured "to have their children conform in their behavior, Zito said. She also said there is a much greater acceptance in the 1990s of psychoactive drugs.
 
She also said that some of the uses for the drugs are not included in warning materials on drug packages. While this is not uncommon with some drugs for adults " such as using aspirin to help prevent heart problems " there may not be enough information on how the psychotropic drugs work for children.
 
Heath,s mother has anecdotal evidence suggesting " as the researchers do " that the number of youngsters on psychiatric drugs is still rising. Through her involvement in Internet support groups for parents of children with behavior problems, Michele Barker said she is hearing of more and more 3- and 4-year-olds being put on drugs like Prozac.
 
"It,s become a quick fix, said Barker, 39, of Hot Springs, Ark.
 
STUDY DETAILS
 
The authors reviewed Medicaid prescription records from 1991, 1993 and 1995 for preschoolers from a Midwestern state and a mid-Atlantic state; and for those in an HMO in the Northwest. The states were not identified.
 
Use of stimulants, antidepressants, antipsychotics and clonidine " a drug used in adults to treat high blood pressure and increasingly for insomnia in hyperactive children " were examined. Substantial increases were seen in every category except antipsychotics, though in some cases the actual number of prescriptions was quite small.
 
The number of children getting any of the drugs totaled about 100,000 in 1991, and jumped 50 percent to 150,000 in 1995. That year, 60 percent of the youngsters on drugs were age 4, 30 percent were 3 and 10 percent were 2-year-olds.
 
The use of clonidine skyrocketed in all three groups. Although the numbers were small, the researchers said the clonidine increases were particularly remarkable because its use for attention disorders is "new and largely uncharted. They noted that slowed heart beat and fainting have been reported in children who use clonidine with other medications for attention disorders.
 
MENTAL HEALTH CRISIS,
 
"One possible contributing factor is the way mental health services are provided to children, Dr. Joseph T. Coyle of Harvard Medical School,s psychiatry department wrote in an editorial accompanying the study. "For example many state Medicaid programs now provide quite limited reimbursement for the evaluation of behavioral disorders in children and preclude more than one type of clinical evaluator per day.
 
"Thus, the multidisciplinary clinics of the past that brought together pediatric, psychiatric, behavioral and family dynamic expertise for difficult cases have largely ceased to exist. As a consequence it appears that behaviorally disturbed children are now increasingly subjected to quick and inexpensive pharmacologic fixes ... he added.
 
"These disturbing prescription practices suggest a growing crisis in mental health, he said. f Dr. David Fassler, chairman of the American Psychiatric Association,s council on adolescents and their families, said the medications studied "can be extremely helpful for some children, even quite young children. But they should be prescribed only after a comprehensive evaluation and in conjunction with other therapy, he said.
 
Their use is increasing in part because doctors are getting better at diagnosing behavior disorders at an early age, Fassler said.
 
However, because their effects on younger children and their development aren,t known, Fassler said, the Food and Drug Administration has recently instructed pharmaceutical companies to study the connection.
 
Barker said Ritalin calmed her son and helped him do well in school. But it also stole his bubbly personality, so she took him off it after four years.
 
"He started becoming the so-called zombie, she said. The family altered his diet and tried nutritional supplements instead.
 
Now almost 12 and drug-free for nearly four years, Heath is repeating fifth grade and has some learning difficulties. But his mother said he seems happier, and so is she.
 
"I don,t care if he,s not an honor roll student, she said, "because he,s healthy.
 
The Associated Press and Reuters contributed to this report.
 

 
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