[CTRL] Prescription of Psychotropics to Preschoolers
-Caveat Lector- A HREF="http://www.ctrl.org/" /A -Cui Bono?- druggin' the babies.. a brave new world.. ? Dave Hartley http://www.asheville-computer.com/dave Trends in the Prescribing of Psychotropic Medications to Preschoolers Julie Magno Zito, PhD; Daniel J. Safer, MD; Susan dosReis, PhD; James F. Gardner, ScM; Myde Boles, PhD; Frances Lynch, PhD Context Recent reports on the use of psychotropic medications for preschool-aged children with behavioral and emotional disorders warrant further examination of trends in the type and extent of drug therapy and sociodemographic correlates. Objectives To determine the prevalence of psychotropic medication use in preschool-aged youths and to show utilization trends across a 5-year span. Design Ambulatory care prescription records from 2 state Medicaid programs and a salaried group-model health maintenance organization (HMO) were used to perform a population-based analysis of three 1-year cross-sectional data sets (for the years 1991, 1993, and 1995). Setting and Participants From 1991 to 1995, the number of enrollees aged 2 through 4 years in a Midwestern state Medicaid (MWM) program ranged from 146,369 to 158,060; in a mid-Atlantic state Medicaid (MAM) program, from 34,842 to 54,237; and in an HMO setting in the Northwest, from 19,107 to 19,322. Main Outcome Measures Total, age-specific, and gender-specific utilization prevalences per 1000 enrollees for 3 major psychotropic drug classes (stimulants, antidepressants, and neuroleptics) and 2 leading psychotherapeutic medications (methylphenidate and clonidine); rates of increased use of these drugs from 1991 to 1995, compared across the 3 sites. Results The 1995 rank order of total prevalence in preschoolers (per 1000) in the MWM program was: stimulants (12.3), 90% of which represents methylphenidate (11.1); antidepressants (3.2); clonidine (2.3); and neuroleptics (0.9). A similar rank order was observed for the MAM program, while the HMO had nearly 3 times more clonidine than antidepressant use (1.9 vs 0.7). Sizable increases in prevalence were noted between 1991 and 1995 across the 3 sites for clonidine, stimulants, and antidepressants, while neuroleptic use increased only slightly. Methylphenidate prevalence in 2 through 4-year-olds increased at each site: MWM, 3-fold; MAM, 1.7-fold; and HMO, 3.1-fold. Decreases occurred in the relative proportions of previously dominant psychotherapeutic agents in the stimulant and antidepressant classes, while increases occurred for newer, less established agents. Conclusions In all 3 data sources, psychotropic medications prescribed for preschoolers increased dramatically between 1991 and 1995. The predominance of medications with off-label (unlabeled) indications calls for prospective community-based, multidimensional outcome studies. JAMA. 2000;283:1025-1030 The prevalence of psychotropic medication treatment for children and adolescents with emotional and behavioral disorders has significantly increased in the United States during the last few decades, particularly in the last 15 years. Specifically, the 5 through 14-year-old age group has experienced a great increase in stimulant treatment for attention-deficit/hyperactivity disorder (ADHD), and the 15 through 19-year-old age group has had sizable increases in the use of antidepressant medications.1, 2 Approved and unapproved indications for psychotropic medications in young children are not extensive. These include: short-term use of analgesics and sedatives/hypnotics for pain relief; hydroxyzine for situational anxiety associated with medical, presurgical, and dental procedures; tricyclic antidepressants for nocturnal enuresis (6-year-olds and older); and amphetamines for ADHD in those 3 years old and older.3 Accordingly, the prevalence of psychotropic medication treatment for children younger than 5 years old has not received much professional attention until recently.4-6 Concern about this age group relates to off-label (unlabeled) use, ie, for treatment indications with little or no proven efficacy and lacking product package insert labeling information approved by the US Food and Drug Administration (FDA).7 One psychiatric newsletter, citing FDA-compiled marketing data, reported that 3000 prescriptions for fluoxetine hydrochloride were written for children aged younger than 1 year in 1994.8 In a 1998 professional meeting report,5 pediatric researchers noted that 57% of 223 Michigan Medicaid enrollees aged younger than 4 years with a diagnosis of ADHD received at least 1 psychotropic medication to treat this condition during a 15-month period in 1995-1996. Of the treatments, methylphenidate and clonidine were prescribed most often. Although the use of psychotropic medication in preschool-aged children compared with older youths is relatively small, the reports cited argue for additional assessment to more systematically estimate its use. Consequently, 3 large, computerized data
Re: [CTRL] Prescription of Psychotropics to Preschoolers
-Caveat Lector- A HREF="http://www.ctrl.org/" /A -Cui Bono?- From: Dave [EMAIL PROTECTED] druggin' the babies.. a brave new world.. ? ...or old news? Just adding a little variance to the barage on our nervous systems that has long been conducted by sugar, cafeine, chocolate, television, religious hype, etc... The more of a barage we are subject to, the more we have to turn to "those we trust" for our sense of what is real, as our own apparatus for discerning reality is crippled - the 'deer in the headlights' phenomenon that many net surfers suffer from. __ Get Your Private, Free Email at http://www.hotmail.com A HREF="http://www.ctrl.org/"www.ctrl.org/A DECLARATION DISCLAIMER == CTRL is a discussion informational exchange list. Proselytizing propagandic screeds are not allowed. Substancenot soap-boxing! These are sordid matters and 'conspiracy theory'with its many half-truths, misdirections and outright fraudsis used politically by different groups with major and minor effects spread throughout the spectrum of time and thought. That being said, CTRL gives no endorsement to the validity of posts, and always suggests to readers; be wary of what you read. CTRL gives no credence to Holocaust denial and nazi's need not apply. Let us please be civil and as always, Caveat Lector. Archives Available at: http://home.ease.lsoft.com/archives/CTRL.html http:[EMAIL PROTECTED]/ To subscribe to Conspiracy Theory Research List[CTRL] send email: SUBSCRIBE CTRL [to:] [EMAIL PROTECTED] To UNsubscribe to Conspiracy Theory Research List[CTRL] send email: SIGNOFF CTRL [to:] [EMAIL PROTECTED] Om
Re: [CTRL] Prescription of Psychotropics to Preschoolers
-Caveat Lector- A HREF="http://www.ctrl.org/" /A -Cui Bono?- What a moron. Sugar, caffeine chocolate are comparable in his mind to powerful psych-drugs? The OLD NEWS is that there are, in every group of people interested in exposing insane trends such as psychotropic drug prescriptions to pre-schoolers increased by 70% in a 5 year period --- Planted disinformationists whose task it is to defuse and spin the information. I doubt if too many of the readers here are likely to be affected by the spin-control tactics of Mr."deer-in-the-road" -- but it does need to be pointed out, I think. Dave Hartley http://www.asheville-computer.com/dave -Original Message- From: Conspiracy Theory Research List [mailto:[EMAIL PROTECTED]]On Behalf Of Will North Sent: Saturday, February 26, 2000 12:42 PM To: [EMAIL PROTECTED] Subject: Re: [CTRL] Prescription of Psychotropics to Preschoolers -Caveat Lector- A HREF="http://www.ctrl.org/" /A -Cui Bono?- From: Dave [EMAIL PROTECTED] druggin' the babies.. a brave new world.. ? ...or old news? Just adding a little variance to the barage on our nervous systems that has long been conducted by sugar, cafeine, chocolate, television, religious hype, etc... The more of a barage we are subject to, the more we have to turn to "those we trust" for our sense of what is real, as our own apparatus for discerning reality is crippled - the 'deer in the headlights' phenomenon that many net surfers suffer from. __ Get Your Private, Free Email at http://www.hotmail.com A HREF="http://www.ctrl.org/"www.ctrl.org/A DECLARATION DISCLAIMER == CTRL is a discussion informational exchange list. Proselytizing propagandic screeds are not allowed. Substancenot soap-boxing! These are sordid matters and 'conspiracy theory'with its many half-truths, misdirections and outright fraudsis used politically by different groups with major and minor effects spread throughout the spectrum of time and thought. That being said, CTRL gives no endorsement to the validity of posts, and always suggests to readers; be wary of what you read. CTRL gives no credence to Holocaust denial and nazi's need not apply. Let us please be civil and as always, Caveat Lector. Archives Available at: http://home.ease.lsoft.com/archives/CTRL.html http:[EMAIL PROTECTED]/ To subscribe to Conspiracy Theory Research List[CTRL] send email: SUBSCRIBE CTRL [to:] [EMAIL PROTECTED] To UNsubscribe to Conspiracy Theory Research List[CTRL] send email: SIGNOFF CTRL [to:] [EMAIL PROTECTED] Om A HREF="http://www.ctrl.org/"www.ctrl.org/A DECLARATION DISCLAIMER == CTRL is a discussion informational exchange list. Proselytizing propagandic screeds are not allowed. Substancenot soap-boxing! These are sordid matters and 'conspiracy theory'with its many half-truths, misdirections and outright fraudsis used politically by different groups with major and minor effects spread throughout the spectrum of time and thought. That being said, CTRL gives no endorsement to the validity of posts, and always suggests to readers; be wary of what you read. CTRL gives no credence to Holocaust denial and nazi's need not apply. Let us please be civil and as always, Caveat Lector. Archives Available at: http://home.ease.lsoft.com/archives/CTRL.html http:[EMAIL PROTECTED]/ To subscribe to Conspiracy Theory Research List[CTRL] send email: SUBSCRIBE CTRL [to:] [EMAIL PROTECTED] To UNsubscribe to Conspiracy Theory Research List[CTRL] send email: SIGNOFF CTRL [to:] [EMAIL PROTECTED] Om
