More than one percent of American preschool children on Medicaid are taking psychiatric drugs, such as antidepressants, mood stabilizers, and medications for attention-deficit disorder, according to a new study.
“Although the absolute numbers and percentages of these drugs were small, these findings are worrying in so far as they indicate the use of psychotropic drugs among very young children,” the authors wrote in the study.
Researchers from Brown School at Washington University in St. Louis and Washington University School of Medicine in St. Louis evaluated data from the 2000-2003 Medicaid Analytic Extract from 36 states and found that preschoolers are receiving psychotropic (affecting mood, perception or behavior) medications despite limited evidence supporting safety or efficacy.
“Because we don’t have indications in our data, it is not entirely clear why these children are receiving psychotropic drugs,” said lead author Lauren Garfield, Ph.D.
The researchers used logistic regression to determine the odds of receiving medications for attention-deficit disorder/attention-deficit hyperactivity disorder (ADHD), depression or anxiety and psychotic illness or bipolar.
“It is possible that some of these children have brain injuries or insults, such as traumatic brain injuries, fetal alcohol syndrome, or the like, for which treatment is being provided.
“But if these medications are being used solely for behavioral control, then it seems clear that we need to better assess these children, and see if they might be better served by the use of evidence-based behavioral interventions,” said co-author Ramesh Raghavan, M.D., Ph.D.
“The fact that any children this small are using psychotropic drugs is very worrisome.”
Between 2000 and 2003, 1.19 percent of children received a prescription for ADHD, depression or anxiety, or psychotic illness or bipolar medication. In addition, 0.17 percent of infants younger than one year old and 0.34 percent of children between one and two years were being prescribed psychotropic drugs.
Overall, 0.61 percent of children received a prescription for ADHD, 0.59 percent for depression or anxiety and 0.24 percent for psychotic illness or bipolar disorder.
JooYeun Chang, associate commissioner of the Children’s Bureau at the administration for Children and Families (ACF), is helping to lead the effort on the federal level to reduce unnecessary psychotropic medication use among child welfare populations.
“Increased access to timely and effective screening, assessment, and non-pharmaceutical treatment will reduce over-prescription of psychotropic medication as a first-line treatment strategy, improve their emotional and behavioral health, and increase the likelihood that children in foster care will exit to positive, permanent settings, with the skills and resources they need to be successful in life,” said Chang.
The results of the study are published in the American Journal of Public Health.