No Antipsychotic Drugs for Children
Antipsychotic drugs are the most potent brain altering chemicals; 90% of the
antipsychotics prescribed to children were: clozapine, risperidone, olanzapine,
and quetiapine. None of these drugs are approved for treating adolescents or
children.
There has been a sharp rise over the last decade in the prescription of
psychiatric drugs for children, including antipsychotics, stimulants like
Ritalin and antidepressants. The explosion in the use of drugs can be traced in
part to the growing number of children and adolescents whose problems are given
psychiatric labels once reserved for adults. Researchers, who analyzed data from
a national survey of doctors' office visits, found that antipsychotic
medications were prescribed to 1,438 per 100,000 children and adolescents in
2002, up from 275 per 100,000 in the two-year period from 1993 to 1995.
Pathak et al and colleagues found increases in the number of children younger
than 18 years in Virginia, USA newly treated with an antipsychotic drug; the
rate doubled between 2001 and 2005. There sample sample included 11,700
children. They also found that among new users, 41.3% had no diagnosis for which
treatment was supported by a published study. The highest level of
non–evidence-based use was with aripiprazole at 77.1%. (Pam Harrison. Medscape
Internal Medicine News. Unsupported Antipsychotic Use in Children Widespread.
Accessed online Feb 2010. Also see Psychiatr Serv. February 2010.)
Jacobson wrote:" Modern antipsychotic drugs are increasingly prescribed to
children and adolescents diagnosed with a broad variety of ailments. The drugs
help to alleviate symptoms in some disorders, such as schizophrenia and bipolar
disorder, but in others their effectiveness is questionable. Yet off-label
prescribing is on the rise, especially in children receiving public assistance
and Medicaid. Psychotic disorders typically arise in adulthood and affect only a
small proportion of children and adolescents. Off-label prescriptions, however,
most often target aggressive and disruptive behaviors associated with
attention-deficit hyperactivity disorder (ADHD). What's really concerning now is
that a lot of this prescription is occurring in the face of emerging evidence
that there are significant adverse effects that may be worse in youth than in
adults. (Roni Jacobson. Should Children Take Antipsychotic Drugs? Prescriptions
are on the rise, but evidence for the drugs' safety and effectiveness is mixed.
Sc American March 2014)
First-time, antipsychotic use in children and adolescents is associated with
rapid and significant weight gain as well as hyperlipidemia, and insulin
resistance. A study of 272 pediatric patients showed that after a median of 10.8
weeks of treatment with antipsychotic medications, subjects gained an average of
18.7 pounds with olanzapine, 13.4 pounds with quetiapine, 11.7 pounds with
risperidone, and 9.7 pounds with aripiprazole. A total of 10% to 36% of study
participants transitioned to overweight or obese status within 11 weeks. (JAMA.
2009;302:1765–1773)
In the USA, Harris stated: “As states begin to require that drug
companies disclose their payments to doctors for lectures and other services, a
pattern has emerged: psychiatrists earn more money from drug makers than doctors
in any other specialty. How this money may be influencing psychiatrists and
other doctors has become one of the most contentious issues in health care. For
instance, the more psychiatrists have earned from drug makers, the more they
have prescribed a new class of powerful medicines known as atypical
antipsychotics to children, for whom the drugs are especially risky and mostly
unapproved. Drug makers generally spend twice as much to market drugs as they do
to research them. ” (New York Times June 2007)
Harris pointed to yet another warning from a panel of federal drug experts
convened by the FDA in the US (2008) that antipsychotic medicines are being used
far too often in children with substantial risks. More than 389,000 children and
teenagers were treated in 2007 with Risperdal, one of five popular medicines
known as atypical antipsychotics; 240,000 were 12 or younger. The drug was often
prescribed to treat attention deficit disorders, an indication not approved
Involving risks which are “too profound to justify its use in treating such
disorders." The same concerns concerns applied to the other drugs in its class,
including Zyprexa, Seroquel, Abilify and Geodon.
The findings on the rising are likely to inflame a continuing debate about
the risks of using psychiatric medication in children. In recent years,
antidepressants have been linked to an increase in suicidal thinking or behavior
in some minors, and reports have suggested that stimulant drugs like Ritalin may
exacerbate underlying heart problems.
Antipsychotic drugs also carry risks: rapid weight gain and blood lipid
changes that increase the risk of diabetes. None of the most commonly prescribed
antipsychotics is approved for use in children, only a handful of small studies
have been done in children and adolescents.
(Reuters Health Information & Carey B. NYT June 6 2006. Reference Arch
Gen Psychiatry 2006;63:679-685 Gardiner Harris. Use of Antipsychotics in
Children Is Criticized. NYT November 19, 2008.)
