And in the seven years leading up to 2001, researchers at Brandeis University, reporting in 2006, found that prescriptions for psychiatric drugs for teenagers (ages 14 to 18) increased 250%. By 2001, one in every 10 medical office visits by teenage boys resulted in a prescription for a psychiatric drug, according to the study in the journal Psychiatric Services.
There's also evidence that such diagnoses and their medication are being dispensed at younger and younger ages. The study of Tennessee children found hikes in antipsychotic use even in preschoolers.
After a 4-year-old Massachusetts girl died of a psychiatric drug overdose in December 2006, the state undertook a first-of-its-kind review of medication records for children in its insurance program for low-income families. It found that nearly 1,000 children under 7 were taking Clonidine, a drug used to treat anxiety and hyperactivity that was found in lethal doses in the body of the Massachusetts 4-year-old. More than 500 kids under 7 were taking antipsychotic drugs.
The state is now investigating 33 cases in which a child under 5 is taking at least three psychiatric drugs on a regular basis, and more such cases are expected to surface.
That growth is taking place amid a debate over the safety and effectiveness in children of many widely prescribed drugs and drug combinations that have not been extensively tested on them.
All told, only 12 medications have been approved by the Food and Drug Administration for treatment of psychiatric disorders in children under 18. Six -- mostly stimulants -- are used by an estimated 3.5 million kids to treat ADHD, a condition estimated by the government to affect 2.2 million to 3.7 million American children. Six -- fluoxetine (Prozac), sertraline (Zoloft), clomipramine (Anafranil), fluvoxamine (Luvox), lithium and risperidone (Risperdal) -- are used to treat symptoms of "mood disorders," including depression, anxiety disorders and bipolar disorder, in kids.
But psychiatrists have also tapped extensively into the formulary of psychotropic medications FDA-approved only for adults. They often prescribe them in combinations that have been the subject of few trials for safety and effectiveness. Such "off-label" prescribing, which is legal, is done often, but not exclusively, when drugs approved for kids don't provide satisfactory results.
