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Children's Health

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Preschoolers' Use of Psychiatric Drugs Levels Off, Study Shows

Findings suggest doctors may have safety concerns


However, the research did reveal increased use of these medications among certain groups: boys, white children and kids without private health insurance during the overall study period, 1994-2009.

ADHD was the most common diagnosis, the researchers found, and stimulants to treat it were the most frequently prescribed psychiatric medications.

The study took its data from government surveys of more than 43,000 pediatric visits to doctor's offices and outpatient clinics across the United States. The 2006 to 2009 visits were the most recent years for which data was available. Froehlich said it's too early to say whether the trend will continue.

Not everyone agrees that the decline in psychotropic medication use was healthy.

"I think the decrease in prescribing is not necessarily a good thing," said Dr. Matthew Lorber, acting director of child and adolescent psychiatry at Lenox Hill Hospital in New York City.

Lorber also thinks the decline is related to the FDA's warning about suicidal thoughts and antidepressants. He said that's a warning that's been largely misconstrued.

"Their goal wasn't to have doctors prescribe them less. It was to have them follow up [with patients] more," he said.

Lorber cited a study published in September 2007 in the American Journal of Psychiatry that found rates of suicide had increased in children and adolescents since the black box warning was issued. The study, he said, could be an indication that antidepressants are being underused in kids.

Still, there are very few studies of psychotropic medication use in very young children. And many doctors aren't comfortable prescribing the drugs off-label -- in this case, giving medications to preschoolers that have only been approved for older children or adults.

"I think we have to be really thoughtful about the use of these medications because we don't really know what they're doing to the brains of developing children," Froehlich said.

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