SAN FRANCISCO, June 7 (UPI) -- The use of psychiatric pharmaceuticals in the very young is on the rise -- along with worries and concerns over its causes and consequences.
Recent studies show, for example, the rate of preschoolers prescribed psychotropic medication tripled between 1990 and 1995.
During the period, orders for mind-altering drugs for tots ages 2 to 4 jumped by 500 percent, according to research led by child psychiatrist Dr. Helen Egger, assistant professor of psychiatry at Duke University Medical Center in Durham, N.C., whose investigations have been funded in part by the pharmaceutical giant Pfizer Inc.
A similar pattern emerged in a study of 2 million insured youngsters that found a 10 percent annual rise between 1998 and 2002 in anti-depressant use in children under 18 -- including of drugs not certified for minors.
Over the five years, the largest jump was for preschoolers 5 and younger, with the rate doubling for girls and going up 64 percent for boys.
Overall in this demographic, use of psychiatric pharmaceuticals jumped 49 percent, from 1.6 percent in 1998 to 2.4 percent in 2002, increasing twice as fast for girls as for boys, researchers said.
The newer selective serotonin reuptake inhibitor anti-depressants topped the drug popularity list.
The rates of anti-depressant use have started to dip since the drugs' labels were affixed in 2004 with the strongest possible warnings of their potential for increasing suicidal thoughts and behaviors in some takers, but it is not yet clear whether the decline portends a long-term trend.
In the five years under study, Paroxetine, the generic name for Paxil, saw a 113-percent boost in use among girls and 91 percent among boys, scientists said.
That's despite a Food and Drug Administration recommendation that the medicine be kept out of children's hands because its safety and effectiveness in this population have not been established and because it has been linked to increased risk of suicidal tendencies and attempts in some users.
The study results reflect booming rates of depression in youth, greater awareness of and screening for the disorder and assumptions that what works for adults should do the same in their underage counterparts, said the authors of an analysis published in Psychiatric Services.
They offered two ways to interpret the findings: efforts to identify and treat depressed youth are paying off -- or children are being prescribed medications before it's been determined whether they will hurt or harm them.
"We've seen increased rates of psychotropic drugs prescribed to preschoolers, and we can wonder, 'What diagnostic criteria are they using?" Egger said.
Her preferred treatment for this age group is "parent training," a technique aimed at helping caretakers learn ways to manage and support the child.
"But there's also another aspect to the story. It's highlighting the fact that there are people whose children are in distress," Egger added. "We need to have better ways to diagnose these problems and treat them, but we also need to acknowledge there is a problem out there."
She hopes to get a better idea of just how big a problem and how best to deal with it during a four-year follow-up of 307 children she and colleagues have been observing since their preschool days.
The investigation, funded by a grant from the McCarthy Foundation, will see the youngsters through the pre-puberty stage.
"My goal is not to label children. My work is not to put all these children on meds," Egger said. "My goal is to find out whether we can do something early so that we can help forestall the kind of distress we're seeing."
"Maybe a less intrusive treatment can have a greater effect at an earlier age," she added. "There's a need now to determine how we are going to thoughtfully, carefully, empirically figure out how to best help these children and their families. It will be science that will tell the story."
Next: Getting to the cause of depression
(Editors' Note: This series on depression is based on a review of hundreds of reports and a survey of more than 200 specialists.)
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