Methylphenidate: In the news

Last modified: Saturday, 20. June 2009 - 1:03 pm

The number of children ages two to four years of age who are being prescribed stimulants such as Ritalin, antidepressants, and other psychiatric drugs soared by 50% from 1991 to 1995, according to a study of 200,000 preschoolers that appeared in the February 23, 2000, Journal of the American Medical Association {JAMA).
The authors of the report, Julie Magno Zito, an assistant professor of pharmacy and medicine at the University of Maryland, and her colleagues, studied the use of psychotropic medications in very young children enrolled in two state Medicaid program and a managed-care organization. The researchers examined data for three psychotropic medication classes: stimulants (methylphenidate, i.e., Ritalin), antidepressants, and neuroleptics (anti-epilepsy drugs). The researchers found that from 1 to 1.5% of all children ages two to four enrolled in those programs were receiving one or the other of those antipsychotic medications. Overwhelmingly, methylphenidate was the leading treatment.
Experts are troubled by the findings because the effects of such drugs on such young and growing children are still unknown. Dr. Joseph T. Coyle of Harvard Medical School’s psychiatry department, in an accompanying JAMA editorial, pointed out that the brains of children that young are still developing. “Early childhood is a time of tremendous change in the human brain,” Coyle said.
Although the study did not examine reasons for the increased use of medications on the children, Zito speculated, in an interview with Society magazine (July 2000), that parents of the children may feel pressured “to have their children conform in their behavior.”
In a commentary in the medical journal Contemporary Pediatrics (May 2000), Dr. Michael G. Burke, chairman of the department of pediatrics at St. Agnes Hospital, Baltimore, asked, “What is a three-year-old learning in preschool that demands enough attention to justify treatment for ADHD? Before playing hard ball with Ritalin, we can almost always hold off until the child enters big-league first and second grade.”
In his JAMA editorial, Coyle offered another reason for the increase in prescription drug use in that age group. He explained that reduced financing for state Medicaid programs have caused those programs to limit what they pay for the evaluation of behavioral disorders in children.
“As a consequence, it appears that behaviorally disturbed children are now increasingly subjected to quick and inexpensive pharmacologic fixes” as opposed to “…(several combinations of) therapy associated with optimal outcomes,” he continued. “These disturbing prescription practices suggest a growing crisis in mental health services to children…”

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