Use of Psychotropic Medications in Preschool Children Leveling Off
One of the largest debates surrounding ADHD is the quick use of medications to treat symptoms, especially in young children. In the 1990’s, over 40 percent of young children - preschool age - were given a prescription for psychotropic medications. But a recent study showed this number has decreased to 29 percent in the 2000’s.
Psychotropic include stimulant medications, antipsychotics, antidepressants, mood stabilizers and anti-anxiety medications. These medications alter the brain’s chemistry, for example stimulant medications (Ritalin, Concerta, Adderall, etc) are thought to increase the amount of dopamine in the brain, which is associated with pleasure, movement and attention. While stimulants do help to decrease symptoms of ADHD, such as hyperactivity and trouble paying attention, most are not approved for preschool age children.
In the mid 1990s, approximately 1 percent of preschool children were receiving psychotropic medications. This peaked in the early 2000s with 1.5 percent of young children receiving a prescription. But in the late 2000s, the the number of children dropped back down to 1 percent, even though the number of diagnosis of mental health conditions, including ADHD, increased. Dr. Tanya Froehlich, the lead author of the recent study, believes doctors are exercising more caution, possibly because of several health warnings issued on the use of these medications:
- In 2004, the FDA issued a black box warning about an increased risk of suicide
- In 2005, amphetamines were linked to cardiovascular risk
- In 2006, and FDA Advisory Committee recommended a black box warning linking psychostimulants to heart problems (this was later reversed)
These warnings may have made doctors prescribe psychotropic medications more cautiously, especially to young children. Froehlich believes this is good news because the effect of these types of medication on the developing brain hasn’t been fully studied.
Interestingly, there are some groups of preschool children who are still increasingly receiving prescriptions for these types of medications: boys, white children and those without private health insurance. The researchers aren’t sure why and believe further research is needed to determine if these prescriptions are appropriate.
A previous study, issued by the Government Accountability Office (GAO) in 2011, found that children in foster care (and on Medicaid) were 2.7 to 4.5 times more likely to be issued a prescription for psychotropic medication than other children on Medicaid. Another study, published in Pediatrics in 2011, found that children in foster care were also more likely to receive a prescription for antipsychotic medications. These higher rates may be due to the exposure to traumatic events experienced by those in foster care.
“Foster Kids Given Psychiatric Drugs at Higher Rates,” 2011, Dec. 1, Jenny Gold, Health News from NPR
“Preschoolers Taking Less Psychotropic Drugs, Doctors ‘Exercising More Caution’,” 2013, Sept 30, Zoe Mintz, International Business Times
“Psychotropic Drugs: What Are They?” 2011, Dec. 2, Enjoli Francis, ABCNews.com
“Psychotropic Use in Preschool-Age Children ‘Stabilizing’,” 2013, Sept 30, Honor Whiteman, medical News Today