Young children are often prescribed psychotropic drugs for pain relief, anxiety, bed wetting and attention-deficit/ hyperactivity disorder. The number of preschoolers in the United States being prescribed antidepressants and stimulants soared 50 percent between 1991 and 1995s, despite limited knowledge about the effects of such drugs on young children.

The number of 2- to 4-year-olds on psychiatric drugs including Ritalin and antidepressants like Prozac jumped 50 percent between 1991 and 1995, in a study of more than 200,000 preschool-age children.

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. 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.

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, it 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. There is a much greater acceptance in the 1990s of psychoactive drugs. It?s become a quick fix.

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. 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.

Since the effects of these medications on such young children are largely unknown, both epidemiological and clinical studies are needed. The researchers state that these findings are remarkable in light of the limited knowledge base that underlies psychotropic medication use in very young children.

Overall, the use of stimulants increased about 3-fold. The majority of stimulant prescriptions were for Ritalin, but there was a modest but consistent decrease in the proportion of methylphenidate use relative to other stimulants across the three time periods. There was a "dramatic" increase in prescriptions for clonidine during the study period. This finding is "notable because its increased prescribing is occurring without the benefit of rigorous data to support it as a safe and effective treatment for attentional disorders.

The Harvard Medical School physician who wrote the editorial to the study states that it appears that behaviorally disturbed children are now increasingly subjected to quick and inexpensive pharmacologic fixes as opposed to informed multimodal therapy associated with optimal outcomes. These disturbing prescription practices suggest a growing crisis in mental health services to children and demand more thorough investigation.

JAMA February 23, 2000;283:1025-1030,1059-1060

Dr. Mercola's Comment:

This is a very sad commentary on the state of traditional medicine in this country. They are willing to sacrifice our children to the pharmaceutical companies and have their parents pay them a ransom of $50 to $100 a month in exchange for a "quick fix" to their medical problems. I really put most of the blame on the physicians. They have the training and are completely capable of researching an appropriate solution for their patients. They have been entrusted to protect and serve their patients and most took an oath to this effect. They have blown it BIG TIME.

Diet will resolve most of the problems for which these drugs are prescribed. I have cared for hundreds if not thousands of these children and it is rare when dramatic if not complete resolution of the behavioral symptoms occur with the diet recommendations.

Fortunately, if you are reading this, you or you loved ones do not need to be held captive to the ignorance (frequently arrogant ignorance) of the majority of physicians when it comes to managing this problem. If you have a child or relative or neighbor who is on these medications have them try the diet.

When it works have them encourage their physician to learn this information so they can start helping other children by getting them off of these dangerous medications which are rarely appropriate. I am delighted to see that JAMA is taking an ever increasingly responsible role by publishing the truth, even when it clashes with the traditional paradigm.

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