10/22/2001 



http://www.usatoday.com/news/healthscience/health/2001-10-
23-kids-drugs.htm





Kids get psychiatric drugs too often



By Marilyn Elias, USA TODAY 



Doctors are increasingly prescribing psychiatric drugs such as 
Ritalin and Prozac to preschoolers, despite questions about safety 
and effectiveness, experts reported over the weekend.



"Every pressure I'm aware of is pushing toward more use of these 
pills in young kids, and the potential for problems is huge," says 
child psychiatrist Glen Elliott of the University of California 
Medical School in San Francisco. He spoke at the American Academy 
of Pediatrics meeting in San Francisco.



HMOs are encouraging quick diagnoses, working parents often can't 
be home to enforce structured behavior-improvement programs, and 
everyone seems to want "quick fixes," Elliott says.



Nobody knows exactly how many preschool children are on 
psychiatric drugs. Some evidence suggests it's only a few out of 
every 100 youngsters. But concern has been mounting since a report 
last year showed that Ritalin use more than tripled in preschoolers 
between 1991 and 1995, and prescriptions for antidepressants 
doubled in that age group during the same period. Newer, 
comprehensive figures are not available.



There are a handful of scientifically sound studies confirming 
Ritalin's effectiveness in 4- and 5-year-olds, says Marsha Rappley, a 
pediatrician at Michigan State University's College of Human 
Medicine in East Lansing. Side effects range from mild to significant 
­ headaches, stomachaches, sleep problems and loss of appetite. But 
there is very little research on safety and effectiveness in kids 
under 4.



Her own recent study of Michigan children 3 and younger diagnosed 
with attention deficit/hyperactivity disorder found a pattern of 
multidrug use: About a third of those treated were taking two or 
three psychiatric drugs.



Mental health services were sparse, "so we may be ignoring their 
core problems and setting the stage for spotty treatment for the 
rest of their lives," Rappley says.



Elliott worries about the long-term dangers of prescribing drugs 
such as Prozac to small children. Antidepressants change how brain 
chemicals work, and permanent changes might result from kids 
taking such drugs "since we know a lot of brain development is still 
going on at this young age," he says.



"To fantasize (that the drugs) can't have adverse consequences is a 
big leap. So far, we've not seen any. But we're not very sophisticated 
at knowing what to look for. There are going to be unanticipated 
effects from such powerful medications," Elliott says.



Parents concerned about preschoolers' behavior problems should 
check with their public schools, Rappley suggests. State and federal 
governments co-fund early treatment programs that may offer the 
best hope for heading off serious emotional problems and avoiding 
use of psychiatric drugs, she says.