|
About 532,000 children ages 6-18 are taking
these drugs without being hospitalized, says child psychiatry
professor Peter Jensen, director of the Center for Children's Mental
Health at Columbia University.
Jensen is part of an expert panel convened to
look into the use of anti-psychotic drugs for children. The drugs
currently of the most concern are newer "atypical anti-psychotics"
such as Risperdal and Zyprexa, which are approved to treat adult
schizophrenia; doctors can legally prescribe them to children
"off-label."
Driven by these new drugs, more than 33.5
million prescriptions were written for anti-psychotics in the USA
last year, up 34% from 1999. Ten years ago, before the new
"atypical" drugs were around, about 50,000 kids were taking
anti-psychotic drugs, mostly while in residential treatment centers.
Jensen and other national experts were asked
to study the issue by New York mental health officials who are
concerned that the new formulations of the drugs are being
overprescribed. A primary worry is the lack of data, "particularly
on the long-term effects in children and adolescents," says Sharon
Carpinello, executive deputy commissioner of the New York State
Office of Mental Health.
While the newer drugs have fewer side effects
than the old-generation anti-psychotics, they aren't risk-free.
Obesity, sedation and diabetes-like symptoms have been reported in
adults and are beginning to show up in children.
A handful of studies — most unpublished —
have shown early success in controlling child aggression,
particularly in kids classified as autistic. Those results have been
"amazing" and "dramatic," says Jensen. "They're probably keeping
some kids out of institutions." But to date, the drugs' effects have
been studied in only about 500 children for one year.
A spokesman for Janssen Pharmaceutica, makers
of Risperdal, says the company is aware its drug is prescribed
"off-label" for kids. "It's safe and effective in adults, and we're
studying its use in children," says Greg Panico.
The expert panel's report will be published
next year in the Journal of the Academy of Child and Adolescent
Psychiatry; Jensen says it will advise that these drugs should
not be used as the first line of treatment for aggression in kids.
And if prescribed as a last resort to curb fighting, hitting and
biting — when a child is a danger to himself and others — the lowest
dosage possible should be used.
Also, the panel's report will warn that there
is a danger of relying on these drugs and ignoring other critical
aspects of appropriate treatment, such as behavior programs,
specially trained teachers and self-contained classrooms.
The report comes amid growing global concern
about psychiatric drugs prescribed to children. The president of the
United Nations International Narcotics Control Board last month
warned that drugs were too often being used to counter social
problems rather than medical ones, and specifically mentioned U.S.
kids being treated for ADHD, or attention deficit hyperactivity
disorder.
Other countries already see the USA as a
place where kids are prescribed too many psychiatric drugs — 90% of
the world's supply of methylphenidate (Ritalin) is used in the USA,
for example, and 80% of the U.S. supply is used by children — and
they worry that the "ADHD culture" will spread to them. The issue
will be the focus of the Associazone Culturali Pediatri (Association
of Cultural Pediatrics) convention in Rome on Oct. 10.
|
