- 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
- 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
- "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
- "It,s become a quick fix, said Barker, 39, of Hot
- 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,
- 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
- SIGHTINGS HOMEPAGE
Site Served by TheHostPros