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Prescriptions for Stimulants, Antidepressants on the Rise for Preschoolers

February 22, 2000 JAMA/MedscapeWire The amount of prescriptions being written for preschoolers for stimulants and antidepressants is on the rise, suggesting increased unapproved use of these medications, according to an article in the February 23 issue of The Journal of the American Medical Association. Julie Magno Zito, PhD, from the University of Maryland, Baltimore, and colleagues studied the prescription records of children aged 2 to 4 years enrolled in 2 Medicaid programs (Midwestern state Medicaid program and Mid-Atlantic state Medicaid program) and 1 health maintenance organization (HMO, in the Northwest United States) to determine the prevalence of psychotropic medication use in preschoolers. Psychotropic medications are drugs such as stimulants, antidepressants, sedatives, and antipsychotic drugs that have an effect on the mind. The researchers analyzed data from 1991, 1993, and 1995 from more than 200,000 patients. “Several prominent trends characterized the use of psychotropic medications in preschoolers during the early to mid 1990s,” the authors explain. “Overall, there were large increases for all study medications (except neuroleptics) and considerable variation according to gender, age, geographic region, and health care system. These findings are remarkable in light of the limited knowledge base that underlies psychotropic medication use in very young children.” In 1995, the prevalence rates per 1,000 2- through 4-year-old children in the Midwestern state Medicaid program were 12.3 for stimulants, 3.2 for antidepressants, and 2.3 for clonidine; in the mid-Atlantic state Medicaid program prevalence rates were 8.9 for stimulants, 1.6 for antidepressants, and 1.4 for clonidine; and in the HMO program prevalence rates were 5.1 for stimulants, 0.7 for antidepressants, and 1.9 for clonidine. Increases in prevalences were noted...

Deadly Drug Side Effects

Drug side effects can be deadly in children under 2 Last Updated: 2002-11-05 11:06:07 -0400 (Reuters Health) By Natalie Engler NEW YORK (Reuters Health) – Medications used to treat either a mother or child played a role in nearly 6,000 serious side effects, including 769 deaths, in children under 2 years of age in the US between 1997 and 2000, according to an analysis of cases reported to the Food and Drug Administration. Medications given to pregnant or breast-feeding women may have caused a large proportion of adverse events, and just four drugs were the principal suspect in more than one third of all the reported deaths. “The results of this study underscore the need for additional testing in the youngest pediatric patients and for greater vigilance in the use of higher risk drugs and in medication for pregnant and lactating women,” the researchers report in the November issue of the journal Pediatrics. However, they note that the reports do not prove that the medication was the actual cause of the side effect or death. Overall, the investigators identified 1,902 drugs, chemicals, biological products, vaccines, over-the-counter medications, vitamins, minerals, dietary supplements and other substances in the reports, but just 17 drugs were indicated in more than half of the serious side effects or deaths in children given medication directly. The vast majority of deaths (84%) happened before the infant’s first birthday. In the study, Thomas J. Moore of George Washington University in Washington DC and his colleagues analyzed over 7,000 reports of adverse drug reactions in children under age 2 received by the US Food and Drug Administration from...

Kids on Behavioral Meds

The Child Advocate is devoted to children and the parents and professionals that work with them and advocate for them. Children on medication for behavioral problems is a major concern for parents. The information presented at this site is for general use only and is not intended to provide personal advice or substitute for the advice of a qualified professional. If you have questions about the information presented here, please consult the resources listed or other professional in your area. US kids on behavioral meds tripled in a decade NEW YORK, Apr 25 (Reuters Health) – The number of children in the United States prescribed medications to treat depression, attention-deficit/hyperactivity disorder (ADHD) or other behavioral conditions nearly tripled between 1986 and 1996, according to the results of a study. The overall annual rate for the prescription of these types of medications–called psychotropic medications because they aim to treat emotional/behavioral conditions–was 14 children per 1,000 in 1987 and increased to 39 children per 1,000 in 1996, the investigators found. In the study, Dr. Mark Olfson of Columbia University in New York City and colleagues reviewed surveys of medication use for more than 50,000 people including about 17,000 children under the age of 18 years in 1986 and 1996. The findings are published in the May issue of the Journal of the American Academy of Child and Adolescent Psychiatry. Olfson and his team found that the number of children taking stimulants such as Ritalin and Adderall, used to treat ADHD, quadrupled from 6 children per 1,000 in 1986 to 24 per 1,000 in 1996. Those taking antidepressants such as Prozac or...

House Democratic Policy Committee’s Public Hearing on the Use of Ritalin

Testimony by House Democratic Policy Committee’s Public Hearing on the Use of Ritalin Presented December 14, 1999 and Revised 2005 Issues Definitions of ADHD Associated conditions Treatment issues   ADHD issues in adults   Is this a marketing scheme to sell Ritalin? No, the use and effectiveness of Ritalin is well established. Ritalin is referenced in 1157 studies in medical journals from 1960 to 1999 and the evidence overwhelmingly supports the therapeutic benefits. About 100 years ago Dr. Still, a pediatrician, defined the disorder.   Original symptoms included hyperactivity, learning problems, inattention and conduct problems.   Is ADD/ADHD just new name for old-fashioned hyperactivity? The name is not as important as the key concept of inattention. Many names are associated with this problem of inattention. Minimal Brain Dysfunction (MBD) was an early name. Others include Hyperactive Child Syndrome Attention Deficit Disorder (ADD) was introduced in 1980   Attention Deficit Hyperactivity Disorder (ADHD) since 1994   Does everyone have ADD? No, a longstanding dysfunctional pattern is necessary. Symptoms or features must be distinguished from a life long pattern before 7 years old. Exuberance is different from symptoms way beyond average and causing dysfunction in life. Using standard rating scales such as Conners or others is necessary for assessment.   Rule out other disorders that can cause similar symptoms   What are the criteria? Inattention   Careless mistakes Not listen   Fail to complete tasks   Impulsivity Frequently interrupts   Shouts out answers   Hyperactivity   Fidgeting Out of seat   Excessive talking   Is the disorder mostly in boys? Yes, boys are often inattentive and hyperactive. Girls do have the...

Children and Psychiatric Medication – a multimodal presentation

Medications for the Child a multimodal presentation A Presentation from Penn State College of Medicine   Highlights of the presentation on psychiatric medication for the child include: Medication in ADHD, Anxiety and Depression Multimodal Treatment Study of Children with ADHD (MTA) Pediatric OCD, Treatment of OCD, and Cognitive Behavioral Therapy Treatment of Adolescent Depression Study (TADS)...

Risperidone Tolerability in Children

Presented at the American Psychiatric Association, 2002 Annual Meeting Hong Chen, M.D., Department of Psychiatry, Hershey Medical Center; Christopher A. Petersen, M.D. Introduction: Little published data is available to determine the tolerability of Risperidone in children in an acute setting. Method: In this prospective pilot study, hospitalized children (n = 10) with age range of 7 to 10 year, were administered Risperidone gradually to 0.04 mg/kg/day as clinically indicated and only if tolerated. Side effect rating scales were completed at baseline, within 24 hours of first dose to assess acute change, at 0.04mg/kg/day if possible to assess effects of therapeutic dosage, and prior to discharge. The average study period is 10 days. Results: Among 10 hospitalized children with newly started on Risperidone, three (30%) developed mild degree of loss of appetite with one also had diarrhea, one (10%) developed mild rigidity, drooling, slurred speech within 24 hours of first dose, one(10%) had mild sedation. In terms of short term weight change by discharge, three (30%) children gained average weight of 0.9 kg, one (10%) lost 0.7 kg. Nine children were discharged on Risperidone without remaining problems of loss of appetite, diarrhea and sedation except weight change, and one child had to discontinue and switch to another neuroleptics. Conclusion: The study demonstrated unexpected high rate of side effect but with short duration and mild severity in children who take Risperidone. More studies regarding long term sequelea of weight change, and presence of EPS symptoms in children on Risperidone are needed in future...