During a routine review of the safety of Johnson & Johnson’s atypical antipsychotic Risperdal and Eli Lilly’s Zyprexa, a panel of experts consulting with the U.S. Food and Drug Administration (FDA) expressed their concern for the increasing amount of prescriptions of these drugs to children, even those under age 12.
Neither these two drugs, nor any other atypical antipsychotic has been approved for prescription to children for most common childhood mental health concerns, namely attention deficit disorder (ADHD) or conduct disorder. Furthermore, there has been zero long-term studies on the effects these drugs may have on a child’s brain development.
The panel of experts is worried that the drugs are being too readily prescribed by doctors unfamiliar with their potency and side effect profile that may be especially harmful to children — substantial weight gain, metabolic disorders and muscular tics that can become permanent if not carefully monitored.
The situation has become alarming:
More than 389,000 children and teenagers were treated last year with Risperdal, one of five popular medicines known as atypical antipsychotics. Of those patients, 240,000 were 12 or younger, according to data presented to the committee. In many cases, the drug was prescribed to treat attention deficit disorders.
Because of the reasons noted above, the panel recommended that the FDA do more to discourage prescriptions of these types of medications in children, especially when the FDA has not approved the use of these drugs for most childhood disorders.
Both drug makers and the FDA basically threw up their hands in response and said, “Hey, we already have strong warnings on these medications, what more can we do?”
Gee, I don’t know, how about issuing an alert to doctors to tell them to stop prescribing these medications off-label for children so young? The data don’t support such prescriptions, and the long-term data is virtually non-existent. Docs (and parents pushing the docs) should stop reaching for every possible new drug to help children when, especially for a disorder like ADHD, there are powerful, fast non-drug treatments available (such as psychotherapy).
Physicians, and especially pediatricians and family docs who are doing a lot of this prescribing, need to just plain stop it. I’m not sure who sold them on the safety and efficacy of these medications in children, but they should only be used as a treatment of last resort, when other, less powerful medications or behavioral treatments have already been tried. Parents should stand up more often and learn a little bit about these medications before okaying them for their children, too. While certainly an option for treatment, they should rarely be the first option for most children.
Read the full story: Use of Antipsychotics in Children Is Criticized
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From Psych Central's World of Psychology:
Nebraska’s Abandoned Kids are Mostly Mentally Ill - World of Psychology (11/20/2008)
4 Comments to
“FDA Advisors: Stop the Overuse of Atypical Antipsychotics in Children”
Great post. I couldn’t agree more about the overuse of meds while psychotherapy, etc, isn’t explored. I’ve linked to this from my blog–thanks for the info!
Thanks for posting this. I’m just curious. You don’t happen to know the break down of doctor’s prescribing these meds? Percentage of Pediatricians, GP’s, & Psychiatrists? I am working with my company in developing a program to address these issues, & help people identify alternatives to meds when appropriate. This article and its findings show that not only do the patients need more education on MH services, but the doctors do to. Thanks.
I agree with the appropriate use of medication for adhd when the risk reward ratio calls for it. That is, when behavioral/counseling remedies are insufficient and the child’s self esteem and grades are suffering due to his or her adhd. I have seen children become literally ostracized from other students and from their teachers (and to some extent from their families as well) and I’ve seen them develop more serious behavioral and social issues just because they can’t get their adhd in hand without medication.
That said, I believe in placing the child on medication designed for that purpose. There are a few adhd medications that have been around for some time now, so we’ve had the opportunity to see children use them over time.
And if the child truly does suffer from add/adhd, placing the child on one of those medications only makes it become more obvious that adhd was the issue due to the night and day difference brought on by the medication. I’ve seen the appropriate use of adhd medication help children regain their self esteem and their momentum in school.
I do NOT think it is safe, nor do I think it is a good thing, to start shoving heavy duty antipsychotic psychotropic meds at young children when we never do studies on anyone but adults, we don’t have dosing guidelines for children, and we don’t know how these drugs will affect the growth and development of the brain long term.
I have seen this happen in particular with children in foster care, many of whom are disturbed at an increasingly young age. I have seen them prescribed what I can only term as some very “adult” psych meds even as they are enrolling in kindergarten.
I understand that many of these children are difficult to manage, and many of them do have some profound mental health issues for their age. But using medication that is untested in their age group makes me very uncomfortable in terms of both the short term and the long term safety of the children involved.
I was on antipsychotics as a teenager and the side effects were horrible. When I was 14, I was put on Risperdal. The side effects were so horrible and I wasn’t warned about them at all. at 15, I was put on Abilify. The side effects were awful, I developed Akathisia, a movement disorder which is severe itnernal restlessness. A couple years later, I was put on Seroquel. The side effects of these drugs are awful. I was a teenager on these drugs and they did horrible things to me, the side effects are things I wouldn’t wish on my worst enemy. I had no idea what was going on. I just wanted to be a regular teenager and these horrible drugs ruined that. Now I’m 21 and off all drugs. I was put on my first antipsychotic in eighth grade. That is completely unacceptable. I am still furious with my parents for allowing this.
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Last reviewed: By John M. Grohol, Psy.D. on 19 Nov 2008
