Health & Parenting

Why Does Johnny Take So Many Pills?

May 12, 2000 (Boston) -- School-age kids appear to be doing drugs in record numbers, and they're doing them with the help of parents, educators, and physicians. But the substances in question aren't cocaine, heroin, or ecstasy -- they're Ritalin, Dexedrine, and Prozac, report researchers at a pediatric meeting here.

A review of prescription claims over the past decade among young Medicaid recipients in North Carolina reveals a sharp increase in the number of children and adolescents receiving either Ritalin or similar stimulants, or antidepressants such as Prozac. Most surprising, say Jerry L. Rushton, MD, and colleagues from the University of Michigan, Ann Arbor, and North Carolina Department of Health and Human Services, is an upward trend in the number of kids who are getting both stimulants and antidepressants at the same time. In the study, 30% of children who were taking antidepressants were also on stimulants.

The data suggest one of three possibilities, the authors say: a surge in the diagnosis of previously unrecognized mental disorders among kids, substitution of the drugs for other therapies, or, as many critics suggest, overprescribing.

In an interview with WebMD, Rushton says that parents should use caution when deciding to follow a doctor's recommendation to give stimulants or antidepressants to their children. "I think it's something the parents should take a look at: who the provider is and how that assessment or diagnosis was made. Make sure that the children just don't have symptoms but they also have functional impairments -- they're having problems at home, they're having problems at school, and [the parent should] get multiple reports -- talk to the kids themselves, talk to other kids, talk to teachers. If all those criteria are met, medication may be appropriate for some children, but it really should be thought of in conjunction with counseling and a whole comprehensive treatment program, not just used as a quick fix or an easy way out," he says.

What has many health care providers concerned is that antidepressants have only been approved for certain uses in children over the last few years, and their long-term track record for safety and efficacy in kids is unknown.

But many providers argue that proper use of both types of medication can be a real boon for many children and their families. "I'm seeing more kids who are being placed on the medications, but I'm also seeing a real need for the medications," says Ira Glovinsky, PhD, who was not involved in the study. "These medications really do help children ... A lot of parents go for years and try to get things managed behaviorally, and go from one therapist to another when they're really dealing with a biological problem," says Glovinsky, a psychologist in private practice in West Bloomfield, Mich.