More kids taking antipsychotics for ADHD: study

By Steven Reinberg, HealthDay Reporter
More kids taking antipsychotics for ADHD: study
Unapproved uses of these powerful drugs need further investigation, experts say.

(HealthDay) -- Use of powerful antipsychotic medications such as Abilify and Risperdal to control youngsters with attention-deficit/hyperactivity disorder (ADHD) and other behavior problems has skyrocketed in recent years, a new study finds.

Antipsychotics are approved to treat bipolar disorder, schizophrenia, other serious mental problems and related to autism. But they don't have U.S. approval for ADHD or other childhood behavior problems, and their use for this purpose is considered "off label."

"Only a small proportion of treatment of (6 percent) and adolescents (13 percent) is for FDA-approved clinical indications," said lead researcher Dr. Mark Olfson, a professor of at Columbia University Medical Center in New York City.

"These national trends on the substantial and growing extent to which children diagnosed with ADHD and other disruptive behavioral disorders are being treated with antipsychotic medications," said Olfson.

The researchers found that between 1993-1998 and 2005-2009 that involved a prescription of antipsychotic medication for children jumped sevenfold -- from 0.24 to 1.83 per 100 people. For teens, 14 to 20 years old, the rate rose from 0.78 to 3.76 per 100 people, and for adults, it just about doubled, from 3.25 to 6.18 per 100 people.

Many of the prescriptions for children were ordered by doctors who are not psychiatrists, the researchers found.

Although these drugs can deliver rapid improvement in children with severe conduct problems and aggressive behaviors, it is not clear whether they are helpful for the larger group of children with ADHD, he said. Nor has their long-term effect on children's developing brains been studied.

Olfson said most children and adolescents treated with antipsychotics are not receiving psychotherapy. "This suggests that more needs to be done to increase access and availability of psychosocial interventions," he said.

"Parent management training and cognitive problem-solving skills training are examples of effective but underused treatments for young people with disruptive behavioral problems," he said.

The study, published in the Aug. 6 online edition of the Archives of General Psychiatry, used data from the National Ambulatory Medical Care Surveys from 1993 to 2009. More than 484,000 people were included in total.

The researchers found prescriptions for antipsychotics increased for children and adults. But doctors prescribed more antipsychotics to children and adolescents (68 percent and 72 percent, respectively) than to adults (50 percent).

For children 13 and younger, the most prescribed drug was risperidone (Risperdal). Other drugs included aripiprazole (Abilify), quetiapine (Seroquel) and olanzapine (Zyprexa). Of these drugs, Abilify was most commonly prescribed to adolescents, aged 14 to 20, the study found.

All of these antipsychotics, developed since the 1990s, are considered "atypical" or second-generation antipsychotics.

For elderly patients, the FDA recently issued a Public Health Advisory about atypical antipsychotic medications after determining that death rates are higher for elderly people with dementia when taking atypical antipsychotics.

Dr. Peter Breggin, a psychiatrist from Ithaca, N.Y., and an outspoken critic of widespread antipsychotic use in children, said these drugs damage developing brains.

"We have a national catastrophe," said Breggin. "This is a situation where we have ruined the brains of millions of children."

In controlling behavior, antipsychotics act on the frontal lobes of the brain -- the same area of the brain targeted by a lobotomy, Breggin said.

"These are lobotomizing drugs," he added. "Of course, they will reduce all behavior, including irritability," he said.

Olfson's team found that most children treated with antipsychotic medications are diagnosed with ADHD, oppositional behavior and unspecified disruptive behavioral disorders.

Between 2005 and 2009, controlling "disruptive behavior" accounted for 63 percent of the reason antipsychotics were given to children and almost 34 percent for adolescents, the researchers found.

In contrast, bipolar disorder and depression were the most common reasons these drugs were prescribed to adults during that time period.

Simon Rego, director of psychology training at Montefiore Medical Center/Albert Einstein College of Medicine in New York City, said these drugs have serious side effects, including weight gain, diabetes and heart problems.

"But, perhaps even more important is the finding that a substantial majority of the child antipsychotic visits were for young people diagnosed with disruptive behavior disorders, for which there are currently no FDA-approved antipsychotic medications," he said.

Given the uncertain effects that antipsychotic medications have on cognitive (brain), social and physical development in children and adolescents, it may be necessary to reevaluate clinical practice patterns, Rego said.

Efforts to educate physicians about the safety and effectiveness of antipsychotic medications are also needed, he said.

More information: For more information on antipsychotics, visit the U.S. National Institute of Mental Health.

Related Stories

Report: 1 in 5 of US adults on behavioral meds

Nov 16, 2011

More than 20 percent of American adults took at least one drug for conditions like anxiety and depression in 2010, according to an analysis of prescription data, including more than one in four women.

Recommended for you

Brains transform remote threats into anxiety

Nov 21, 2014

Modern life can feel defined by low-level anxiety swirling through society. Continual reports about terrorism and war. A struggle to stay on top of family finances and hold onto jobs. An onslaught of news ...

Mental disorders due to permanent stress

Nov 21, 2014

Activated through permanent stress, immune cells will have a damaging effect on and cause changes to the brain. This may result in mental disorders. The effects of permanent stress on the immune system are studied by the ...

Could there be a bright side to depression?

Nov 21, 2014

(Medical Xpress)—A group of researchers studying the roots of depression has developed a test that leads them closer to the idea that depression may actually be an adaptation meant to help people cope with ...

User comments

Adjust slider to filter visible comments by rank

Display comments: newest first

freethinking
1 / 5 (1) Aug 07, 2012
Interesting that many people consider spanking a child to teach them right and wrong abuse, yet these same people have no issues drugging their child to make them easier to handle.

Just recently I talked to a parent of 2 children. She almost blew a gasket when I told her I spanked my kids, she thought that was child abuse and it stunted kids independance and growth. She said her kids have ADHD and she placed them on medication and now they are a lot less trouble.

I've also coached kids where parents placed them on these medications. In each case, even though the kids were a handfull to coach, I much preferred the before drugs than after.
DanielHaszard
not rated yet Aug 16, 2012
Risperdal reproached.
Same saga here as Eli Lilly Zyprexa.
Johnson and Johnson is a trusted brand we associate with babies.
Risperdal,Zyprexa,as well as the other atypical antipsychotics, are being prescribed for children, even though this is an unapproved, off-label use. An estimated 2.5 million children are now taking atypical antipsychotics. Over half are being given them for Attention Deficit Hyperactivity Disorder,many of these foster children.
Weight gain, increases in triglyceride levels and associated risks for (life-long) diabetes and cardiovascular disease.
Eli Lilly made $67 BILLION on Zyprexa!
*Tell the truth don't be afraid*
Daniel Haszard FMI
http://www.zyprexa-victims.com

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.