The findings of a recent study, published in the Sept. 30 issue of the journal Pediatrics, suggests the use of psychotropic drugs to treat a variety of mental health disorders in children, including attention-deficit/hyperactivity disorder (ADHD), to be dwindling.
The research group looked at in excess of 43,000 children over 16 years, between the ages of two and five, and established that the overall number of prescriptions authorized for the use of psychotropic drugs boomed around the mid-2000s; this trend then began to plateau during the late 2000s.
In stark contrast, however, the group discovered that white, male participants, and children who did not have access to private health insurance, were more likely to remain on a regime of psychotropic drug use throughout the duration of the study.
The authors of the paper were uncertain as to why these particular categories of young children were more likely to receive long-term psychotropic drug therapy. They suggested that more research should be conducted into this area to assess the suitability of these prescriptions.
The team investigated data between the years of 1994 and 2009, collecting and analyzing data from the National Ambulatory and National Hospital Ambulatory Medical Care Surveys (NAMCS/NHAMCS).
The NAMCS is a national survey that utilizes findings from non-federally hired physicians, and aims to look at the administration of ambulatory medical care services. Meanwhile, NHAMCS investigates the provision of ambulatory care in outpatient departments and hospital emergency settings.
Tanya Froehlich, senior author of the study highlighted that there was an increase in behavioral diagnoses between 2006 and 2009. However, based upon their findings, she maintains that this did not reflect a rise in a practitioner’s propensity towards administering prescriptions of psychotropic medications:
“In fact, the likelihood of psychotropic use in 2006 to 2009 was half that of the 1994 to 1997 period among those with a behavioral diagnosis.”
According to a recent press release, the administration of psychotropic drugs had lessened by 14% from the 1994-1997 period, to the 2006-2009 period. Between 1994 and 1997, the use of psychotropic drugs was 43%, whereas this figure was only 29% from 2006 to 2009, in patients with one or more behavioral diagnoses.
FDA Warnings and Decreased Psychotropic Drug Use
It is speculated that the Food and Drug Administration (FDA) had a major impact upon the prescription of psychotropic drug treatments. Drawing a connection between antidepressants and suicide risk in young people, a black box warning was placed upon the packaging of a great many antidepressant medications alongside the literature that described the drugs.
Black box warnings were mandated by the FDA for atomoxetine in 2005, a selective norepinephrine reuptake inhibitor used to treat ADHD, citing a relationship between the drug’s use and suicidality as the primary reason. During 2007, an FDA advisory committee recommended black box warnings for a range of psychostimulants, and manufacturers of ADHD drugs were then required to inform patients of potential cardiovascular and psychiatric problems.
Froehlich explains the importance of the group’s research, suggesting it underscores the need for medical practitioners to remain educated on “… stringent diagnostic criteria and clinical practice guidelines.” She singles out ADHD as being particularly important, which she describes to be the most common diagnosis derived.
ADHD is a very common neurobehavioral disorder seen in childhood. ADHD sufferers may have difficulty concentrating and may have difficulty restraining impulsive behaviors. Some of the characteristic symptoms of ADHD are as follows:
- Making careless mistakes
- Talking too much
- Forgetful/losing possessions
- Inability to get along with peers
- Difficulty taking turns/resisting temptation
After a successful diagnosis has been confirmed, ADHD is treated using a number of strategies, including behavioral intervention, parent training and administration of medication. Stimulants are the most common means of treating ADHD, with the Centers for Disease Control and Prevention (CDC) reporting a positive response of between 70 and 80 percent.
Froehlich stresses that doctors need to remain up to speed on diagnostic criteria and guidelines to ensure ADHD is accurately diagnosed, whilst stimulants, the most common psychotropic drug prescribed, should be managed effectively.
Despite the dwindling use of psychotropic drugs amongst children, Froehlich would also like to see concerted research efforts, aimed at studying the impact of psychotropic medications on the developing brain:
“… future studies on the long-term effects of psychotropic medication use in this age group are essential.”
By: James Fenner