Whether it’s a marker of our “take a pill, solve a problem” mentality or a genuine effort to address a medical diagnosis with less than laserlike precision, a whole lot of kids are taking a whole lot of seriously psychotropic drugs for problems that don’t necessarily require them.
Psychotropic drugs alter perception, emotion and/or behavior. We’ve covered their misuse in general, but this study focused on children at doctors' offices. It followed a similar study last year that surmised that the increase of these powerful agents for youngsters was probably due to inpatient use.
As reported last month by Reuters, antipsychotic drugs are prescribed in nearly 1 in 3 of all visits by children and teens to psychiatrists in the U.S. That’s a significant increase from the 1990s, when it was about 1 in 11 such visits.
The study of this practice was published in the Archives of General Psychiatry. It concludes that the increase is the result of doctors prescribing the drugs for disruptive behaviors, such as attention deficit/hyperactivity disorder (ADHD), never mind that the FDA does not approve antipsychotics to treat those disorders in kids.
They are approved to treat schizophrenia, bipolar disorder and irritability with autism.
Use of them for other purposes is deemed “off-label,” which isn’t illegal, provided the drug manufacturers don’t promote them for such uses.
The study couldn’t say whether the prescriptions were unnecessary, but their effectiveness for disorders such as ADHD is uncertain. And, like all drugs, they carry the potential for side effects. Antipsychotic drugs can promote weight gain and have been linked to diabetes.
Last year, according to Reuters, a large study of children found that kids who took antipsychotic drugs were four times more likely to develop diabetes than their peers who weren’t taking them.
In September, an FDA advisory panel expressed concern about the drugs’ appropriateness for children, and urged the agency to monitor weight gain and metabolic diseases (diabetes) in children who take them.
Antipsychotic drug use is increasing across all demographic groups, but it’s most accelerated for children and teens. It’s difficult to cite exact numbers because the research concerns only prescriptions written during doctor office visits—clinics, community health centers or other facilities weren’t included. Another complication to being exact about antipsychotic drug use in children is that researchers don’t know how long each patient took the drug or if any prescription was written at a repeat visit by the same patient.
The new study’s lead author has his own prescription for parents whose children might be given an antipsychotic drug prescription at a doctor’s appointment. He advises them to ask more questions about the drugs—why is it being prescribed, what are the intended effects, how soon are they expected to appear, what are the side effects (see our blog, “Questions Patients Should Always Ask”)—and also if there are any alternative treatments.
He said psychosocial interventions (training for parents to manage the behavior from certain disorders) can reduce aggressive and disruptive behaviors in kids. But they take time, and they’re more expensive.
"Perhaps if they were more available, we wouldn't have as much use of these antipsychotic medications," he told Reuters.