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Surge In Anti-Psychotic Drugs Given To Kids Draws Concern

Jul 23, 2002 | USA TODAY

An estimated half-million schoolkids are now taking powerful anti-psychotic drugs -- more than 10 times the number a decade ago -- and some experts worry that too many children are getting these drugs inappropriately to control aggressive behavior.

About 532,000 children ages 6-18 are taking these drugs without being hospitalized, says child psychiatry professor Peter Jensen, director of the Center for Children's Mental Health at Columbia University.

Jensen is part of an expert panel convened to look into the use of anti-psychotic drugs for children. The drugs currently of the most concern are newer ''atypical anti-psychotics'' such as Risperdal and Zyprexa, which are approved to treat adult schizophrenia; doctors can legally prescribe them to children ''off-label.''

Driven by these new drugs, more than 33.5 million prescriptions were written for anti-psychotics in the USA last year, up 34% from 1999. Ten years ago, before the new ''atypical'' drugs were around, about 50,000 kids were taking anti-psychotic drugs, mostly while in residential treatment centers.

Jensen and other national experts were asked to study the issue by New York mental health officials who are concerned that the new formulations of the drugs are being overprescribed. A primary worry is the lack of data, ''particularly on the long-term effects in children and adolescents,'' says Sharon Carpinello, executive deputy commissioner of the New York State Office of Mental Health.

While the newer drugs have fewer side effects than the old-generation anti-psychotics, they aren't risk-free. Obesity, sedation and diabetes-like symptoms have been reported in adults and are beginning to show up in children.

A handful of studies -- most unpublished -- have shown early success in controlling child aggression, particularly in kids classified as autistic. Those results have been ''amazing'' and ''dramatic,'' says Jensen. ''They're probably keeping some kids out of institutions.'' But to date, the drugs' effects have been studied in only about 500 children for one year.

A spokesman for Janssen Pharmaceutica, makers of Risperdal, says the company is aware its drug is prescribed ''off-label'' for kids. ''It's safe and effective in adults, and we're studying its use in children,'' says Greg Panico.

The expert panel's report will be published next year in the Journal of the Academy of Child and Adolescent Psychiatry; Jensen says it will advise that these drugs should not be used as the first line of treatment for aggression in kids. And if prescribed as a last resort to curb fighting, hitting and biting -- when a child is a danger to himself and others -- the lowest dosage possible should be used.

Also, the panel's report will warn that there is a danger of relying on these drugs and ignoring other critical aspects of appropriate treatment, such as behavior programs, specially trained teachers and self-contained classrooms.

The report comes amid growing global concern about psychiatric drugs prescribed to children. The president of the United Nations ( news - web sites) International Narcotics Control Board last month warned that drugs were too often being used to counter social problems rather than medical ones, and specifically mentioned U.S. kids being treated for ADHD, or attention deficit hyperactivity disorder.

Other countries already see the USA as a place where kids are prescribed too many psychiatric drugs -- 90% of the world's supply of methylphenidate (Ritalin ( news - web sites)) is used in the USA, for example, and 80% of the U.S. supply is used by children -- and they worry that the ''ADHD culture'' will spread to them. The issue will be the focus of the Associazone Culturali Pediatri (Association of Cultural Pediatrics) convention in Rome on Oct. 10.

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