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Wednesday February 23 1:12 AM ET

 Study Says More U.S. Kids Given Psychotropic Drugs

CHICAGO (Reuters) - The number of preschoolers in the United States
being prescribed antidepressants and stimulants rose in the mid-1990s
despite limited knowledge about the effects of such drugs on young
children, according to a study published on Tuesday.

``Unresolved questions involve the long-term safety of psychotropic
medications, particularly in light of earlier ages of initiation and longer
durations of treatment,'' said the report published in this week's Journal of
the American Medical Association.

``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 University of Maryland study looked at 200,000 patients in three areas
of the country. It found that use of stimulants and antidepressants rose in all
the areas between 1991 and 1995.

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 aged
3 years and older.

Julie Zito, principal author of the study, said in an interview 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, she said.

``The data that supports the use is essentially anecdotal, or not rigorously
studied,'' Zito said.

In an editorial in the same issue commenting on the study, Joseph Coyle of
Harvard Medical School said, ``Given that there is no empirical evidence to
support psychotropic drug treatment in very young children and that there
are valid concerns that such treatment could have deleterious effects on the
developing brain, the reasons for these troubling changes in practice need
to be identified.''

He said the study does not identify the diagnoses of the children involved or
the medical specialties of those who prescribed the medicines.

``One possible contributing factor is the way mental health services are
provided to children,'' he said. ``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 said.

``These disturbing prescription practices suggest a growing crisis in
mental health,'' he said.

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