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Study Finds Jump in Children Taking Psychiatric Drugs January 14, 2003 By ERICA GOODE The number of children and adolescents who take a wide variety of psychiatric drugs more than doubled from 1987 to 1996, researchers are reporting today. Stimulants like Ritalin, prescribed for attention deficit disorder, and antidepressants were the most commonly prescribed drugs, according to the study, which experts said was the most comprehensive on the topic. The investigators, led by Dr. Julie Magno Zito, an associate professor of pharmacy and medicine at the University of Maryland, also found precipitous growth in the use of antipsychotics, so-called mood stabilizers prescribed for mania or aggression, and other classes of potent psychoactive medications. The study, experts said, further confirms that pediatricians and child psychiatrists are increasingly turning to pharmacology as the treatment of choice for depression, attention disorder, severe anxiety, obsessive disorder, manic depression and other conditions. The effects of the trend, or whether it is good or bad, are unclear, the experts added. On one hand, the findings reflect the emergence of new treatments, advances that have spilled into the care of severely troubled children. On the other hand, little research exists to indicate whether psychiatric drugs are being responsibly prescribed or whether they are overprescribed, in part because health insurers are reluctant to pay for "talk" therapies and other nonmedication treatments. The Food and Drug Administration specifically approves just a few psychiatric medications for children, despite their widespread use. This month, Prozac was approved to treat depression in children ages 7 to 17. The long-term effects of such drugs, particularly on the brain, are largely unknown. "The studies can't tell you anything at all about the quality of care or the outcomes of those treatments," said Dr. James March, a professor of child and adolescent psychiatry at the Duke University Medical Center. "What we know is that mental illness is bad for your life, and an optimist's view would be that treatments, by reducing or ameliorating the symptoms of mental illness, are supporting a more normal developmental trajectory." Dr. James Leckman, a professor of child psychiatry, pediatrics and psychology at the Yale School of Medicine, said psychiatric drugs were useful, but added that animal studies had hinted that some might have lasting effects on the brain when given before puberty. In the absence of added studies in animals and humans, Dr. Leckman said, "we're doing these experiments more or less with our own children." Dr. Zito and her colleagues found that of the 900,000 children and adolescents they studied, 6.2 percent took at least one psychiatric drug in 1996, compared with 2.5 percent in 1987. The participants in the study, which appears today in The Archives of Pediatrics and Adolescent Medicine, were in Medicaid programs in two states and in a large health maintenance organization in the Northwest. In 1996, twice as many boys as girls took psychiatric drugs, the study found. Over the 10 years, the increases in the use of stimulants were greater for girls than boys, especially in the H.M.O. Boys and girls appeared to be taking the drugs for longer periods than they did a decade before. In 1987, children ages 5 to 9 were most likely to be taking Ritalin or another stimulant. In 1996, children ages 10 to 19 took the medications most frequently. The use of stimulants and antidepressants was comparable in the Medicaid and H.M.O. groups. That was not the case for other classes of drugs. The children and adolescents in Medicaid were significantly more likely to be taking antipsychotic drugs and mood stabilizers. The prescribing of drugs like clonidine, an antihypertensive often prescribed for the insomnia produced by stimulants like Ritalin or Adderall, also increased significantly, especially among Medicaid patients. Clonidine, Dr. Zito noted, was almost never prescribed in 1987 but ranked among the five most popular drugs in 1996. In an editorial with the study, Dr. Michael Jellinek, a professor of psychiatry and pediatrics at the Harvard Medical School, called the findings "an imperfect mirror of the scientific, clinical, financial and systems changes that impacted the mental health care of children." The study, Dr. Jellinek said, may reflect new understanding and "thoughtful efforts" to use adult drugs in children "to treat children with serious mental health needs." But he added, "There are some disturbing clinical trends." Dr. Zito said the challenge for researchers was to establish the need for drugs, effective doses, duration of medication, and the risks. "What we want to do," Dr. Zito said, "is to get the right medicine to the right child at the right time, assuming that behavioral approaches are not sufficient by themselves." http://www.nytimes.com/2003/01/14/health/14DEPR.html?ex=1043547607&ei=1&en=faf18c846fdd8b0b HOW TO ADVERTISE --------------------------------- For information on advertising in e-mail newsletters or other creative advertising opportunities with The New York Times on the Web, please contact [EMAIL PROTECTED] or visit our online media kit at http://www.nytimes.com/adinfo For general information about NYTimes.com, write to [EMAIL PROTECTED] Copyright 2002 The New York Times Company <A HREF="http://www.ctrl.org/";>www.ctrl.org</A> DECLARATION & DISCLAIMER ========== CTRL is a discussion & informational exchange list. Proselytizing propagandic screeds are unwelcomed. 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