Posted On: October 18, 2013 by Patrick A. Malone

Doctors Are Prescribing Fewer Psychotropic Drugs

A few years ago, we blogged about the high, atypical use of antipsychotic medicine for children, and the disturbing questions such practices sparked about such widespread use of these powerful drugs. We also wrote about how the boom in diagnoses for attention deficit hyperactivity disorder (ADHD) can lead to overmedicating.

A recent study published the journal Pediatrics, however, shows that by the end of 2009, psychiatric medications were used less often for young children.

Psychotropic drugs, which affect one’s mental state and often his or her cognitive abilities, are powerful meds that can be life-saving for some people. But, like all drugs, they carry risks as well as benefits. Children, whose brains are still developing, could be particularly vulnerable to psychotropic side effects.

We’ve written, for example, about the risk of suicide for some drugs that treat attention deficit hyperactivity disorder (ADHD). And in 2004, the FDA issued a warning about the association between antidepressant use among children and suicide risk.

More recently, an association between diabetes and the use of antipsychotics by children has been shown.

So the fact that the percentage of children who are prescribed antipsychotics, stimulants and antidepressants during doctor visits is lower than it was in the mid-2000s is good news.

Dr. Tanya Froehlich, the study’s senior author, told Reuters.com, "I'm very excited that the use of these drugs in this age group seems to be stabilizing.

"It's good to get a gauge on what we're doing with psychotropic medications in this age group, because we really don't know what these medications do to the developing brain."

Earlier studies looked at the use of psychotropic drugs among preschoolers, but they usually focused on one class of medication or only one segment of the population. For this study, national data for about 43,500 doctors' visits from 1994 to 2009 was used, involving kids ages 2 to 5.

In that time span, Reuters explained, the proportion of psychotropic drug prescriptions varied between one prescription for every 217 doctors' visits in 1998 and one for every 54 visits in 2004.

Between 1994 and 1997, about 1% of preschoolers left the doctor’s office with a psychotropic prescription. Between 1998 and 2001, the percentage declined to about 0.8%. It rose to a high of about 1.5% between 2002 and 2005, and dropped to 1% between 2006 and 2009.

Although the latest figure wasn’t the lowest, it was still notable because the decrease and stabilization occurred while increasing numbers of children were diagnosed with behavioral disorders. More diagnoses, but less treatment with heavy drugs.

The study didn’t explain the lowest rate between 2006 and 2009, but the researchers suggested it might be because of a greater awareness of the meds’ possible side effects.

The drugs have been widely prescribed to address disruptive behavior by preschoolers, so perhaps other behavioral interventions are being tried first, and with at least some success.

"The thing pediatricians should be asking themselves is, ‘Are we really following the guidelines in treating these children?' which is trying behavioral therapy and then going to the medications," Froehlich told Reuters.

See our blog, “Does Your Kid Really Need a Psychotropic Drug,” if you think your doctor might prescribe one to address your child’s behavioral issue. Learn more about these medicines on the National Institutes of Health site, Mental Health Medications.

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