Kids with ADHD Increasingly Treated with Antipsychotics


New findings show that children with attention deficit hyperactivity disorder (ADHD) may be taking the wrong medications.

More kids are receiving strong antipsychotic medications normally given to treat such illnesses as schizophrenia and bipolar disorder. Maggie Fox of NBC News reports that young people are getting these drugs without any kind of diagnosis that would indicate they have a psychiatric disorder, according to the survey.

The drugs can have serious side effects and, most importantly, the children taking them may be missing out on getting the correct treatments for their particular conditions. Michael Schoenbaum of the National Institute for Mental health, who worked on the study, published their paper in the Journal of the American Medical Association publication JAMA Psychiatry. The team studied nationwide prescription data and found a disturbing pattern.

“What’s especially important is the finding that around 1.5 percent of boys aged 10 to 18 are on antipsychotics, and then this rate abruptly falls by half as adolescents become young adults.”

Schoenbaum says the use of these drugs was more consistent with the prescribing of drugs to manage behavioral problems, which are better handled with psychotherapy, behavioral therapy, and stimulant drugs like Ritalin.

“These are an important class of medications,” Schoenbaum said. “They are lifesaving for some people, so the point is not to demonize the medication.”

In short, he says, drugs like clozapin, Haldol, and Zyprexa (olanzapine) are used to calm agitated parents. They flatten and quiet people down, but even people who legitimately need these medications often do not like to take them, saying they make them feel like different people. Other side effects connected to these drugs include weight gain, diabetes risk, tremors, elevated cholesterol, and even affected brain development. The FDA has asked manufacturers to put a warning label on the medications noting the drugs are not approved to treat behavioral problems in patients with dementia, with whom death can result.

The researchers found that 60% of the children surveyed did not get a psychiatric diagnosis along with their prescription. Of the 40% of children who did get psychiatric diagnoses, the most common diagnosis was ADHD. The FDA has not approved the use of antipsychotics for ADHD.

Not only ADHD, but also aggression and behavioral problems in children were regularly treated with antipsychotics.

“There’s been concern that these medications have been overused, particularly in young children,” says Mark Olfson, a professor of psychiatry at Columbia University who led the study. It was published Wednesday in JAMA Psychiatry. “Guidelines and clinical wisdom suggest that you really should be using a high degree of caution and only using them when other treatments have failed, as a last resort.”

NPR’s Nancy Shute writes that according to Christof Correll, a professor of psychiatry at Hofstra North Shore-Long Island Jewish School of Medicine, physicians tend to jump straight to these medications. The reasons for this include a shortage of psychotherapists; the amount of time required for family therapy; and lack of insurance coverage.

Often parents don’t seek help until a child is about to be expelled or is about to be put in juvenile detention. Schoenbaum and his colleagues at Columbia University, Yale University, and the New York State Psychiatric Institute found that the use of antipsychotics was higher among boys, especially teenage boys.

07 6, 2015
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