Psychiatric drug use soars for youth

Prescription rates more than doubled in a decade

Doctors are prescribing psychiatric drugs for children at a rapidly increasing rate, a US study published on Tuesday has found.

The number of young people taking stimulants, anti-depressants, and related drugs increased between two and three times between 1987 and 1996, the study revealed.

Researchers examined data from nearly 900,000 young people in two unnamed US states, making it among the most comprehensive of its kind, the authors said.

Will we value our children sufficiently to ask if we are prescribing the right psychotropic medications to the right children using the right treatment plan?

Michael Jellinek,
psychiatrist

The study does not address the question of whether the drug prescriptions are appropriate.

In their conclusion, the authors point out that by the 1990s, psychiatric drugs were being given to children at nearly the same rate as adults.

The study was published the January 2003 issue of the journal Archives of Pediatrics and Adolescent Medicine.

Interpretations

In an editorial accompanying the study, psychiatrist Michael Jellinek discusses two possible interpretations of the findings.

On the one hand, he said, the increase in use of medication could be due to advances in diagnosis and improvements in drugs.

Young people are taking medicine at almost adult rates

But, he adds, "there were some disturbing clinical trends that limit optimism".

Dr Jellinek argues that the rise in for-profit medical care encourages the use of medication rather than, for example, psychotherapy.

"The use of medications increased steeply at a time when for-profit behavioural managed care companies expanded their influence," he writes.

"Medication visits [to doctors] are reimbursed at twice or more the rate per minute than therapy time, and less rigorous authorisation is required," he continues.

He also points out that pharmaceutical companies have a financial incentive to encourage the use of drugs, and engage in "vigorous marketing at professional meetings... and, most recently, direct-to-consumer advertising".

Dr Jellinek recommends that health care providers submit annual reports on use of psychiatric drug by young patients and conduct yearly quality assurance studies.

He also advises carrying out detailed studies of the "actual cost of child mental health disorders across the health, mental health, school, social service and juvenile justice systems" to avoid merely shifting the problem from one field to another.

"Will we value our children sufficiently," he asks, "to ask if we are prescribing the right psychotropic medications to the right children using the right treatment plan?"