Tuesday, August 5, 2008

Psychotropic Drugs for Children: 75% of their use is "Off Label"

Dr. Julie Zito, professor of pharmacy and psychiatry at the UMB School of Pharmacy (Baltimore, MD) recently authored a study of how psychotropic medications are frequently used on children in the USA. These drugs act on the central nervous system to alter emotion or behavior temporarily.

While Zito's study was specifically how doctors treat youths in foster care, her paper tells us a great deal about the general overuse of these drugs beyond what has been approved by the US Food and Drug Administration.

Because there is a lack of “substantive evidence of their effectiveness and safety,” according to Dr. Zito, this issue should be recognized as a real danger to children. Doctors are over-medicating kids with drugs that were never designed for their growing bodies. "We are generalizing our [knowledge] from adults to children without knowing enough about pharmacokinetics, dosing, or long-term safety in the pediatric population,” warns Zito.

In a study of Texas children with Medicaid coverage, foster care youth received at least three times more psychotropic drugs than comparable children in poor families. But there is no clear treatment advantage to the foster children. The Texas study indicated that decisions to give some children three or more psychotropic drugs may be largely based on behavioral and emotional symptoms rather than conclusive diagnosis of a specific mental condition. “These data do not provide sufficient information to address questions of severity and impairment that might explain such complex drug regimens,” Zito suggests.

These children, it seems, are simply targets for drugs being thrown at them by doctors and pharmaceutical companies with a "who cares" attitude. If it can be billed to Medicaid, than why not.

This study was published earlier this year in the journal Pediatrics. More than 75 percent of the psychotropic medication use for children is off-label, a practice of prescribing drugs for a purpose other than the approved use on its label.



wicle said...

Psychotropic medications, which act on the central nervous system to alter emotion or behavior temporarily, are frequently used to treat youth in foster care

Anonymous said...

I recently saw a case of a child who had been diagnosed with ADHD, but has none of the attentional problems associated with the condition. She was acting out at school and not getting along with others. Her undereducated mother really did not know what to do. The child was placed on ADHD medication but was also lucky enough to get some good counseling and case management. Sadly, the counseling and case management did not come until a bit later, after the child's med dosage had been increased. It was increased because it wasn't working. But even though the child is somewhat improved through the other approaches, she remains on large doses of ADHD medication.