The increasing
use of anti-psychotics since the mid-1990s corresponds with
the introduction of costly and heavily marketed medications
such as Zyprexa and Risperdal. The packaging information for
both says their safety and effectiveness in children have
not been established.
Anti-psychotics are intended for use against
schizophrenia and other psychotic illnesses.
However, attention deficit disorder is sometimes
accompanied by temper outbursts and other disruptive
behavior. As a result, some doctors prescribe
anti-psychotics to these children to calm them down - a
strategy some doctors and parents say works.
The drugs, which typically cost several dollars per pill,
are considered safer than older anti-psychotics - at least
in adults - but they still can have serious side effects,
including weight gain, elevated cholesterol and diabetes.
Anecdotal evidence suggests similar side effects occur in
children, but large-scale studies of youngsters are needed,
Cooper said.
The researchers analyzed data on youngsters age 13 on
average who were involved in annual national health surveys.
The surveys involved prescriptions given during 119,752
doctor visits. The researchers used that data to come up
with national estimates.
Cooper said some of the increases might reflect repeat
prescriptions given to the same child, but he said that is
unlikely and noted that his findings echo results from
smaller studies.
The study appears in the March-April edition of the
journal Ambulatory Pediatrics.
Heavy marketing by drug companies probably contributed to
the increase in the use of anti-psychotic drugs among
children, said Dr. Daniel Safer, a psychiatrist affiliated
with Johns Hopkins University, who called the potential side
effects a concern.
Safer said a few of his child patients with behavior
problems are on the drugs after they were prescribed by
other doctors. Safer said he has let these children continue
on the drugs, but at low doses, and he also does periodic
tests for high cholesterol or warning signs of diabetes.
Dr. David Fassler, a University of Vermont psychiatry
professor, said more research is needed before
anti-psychotics should be considered standard treatment for
attention deficit disorders in children.
"Given the frequency with which these medications are
being used, there's no question that we need additional
studies on both safety and efficacy in pediatric
populations," Fassler said.
