Tom Insel – NIMH – Are Children Overmedicated ?

Director’s Blog: Are Children Overmedicated?

http://www.nimh.nih.gov/about/director/2014/are-children-overmedicated.shtml

A recent symposium at the Carter Center featured a report by the Centers for Disease Control and Prevention (CDC) that as many as 10,000 toddlers may be receiving psychostimulant medication, like methylphenidate (Ritalin).1 The media reports of this, like many past reports, decried the overmedication of children. The numbers are notable.

The latest estimate from the National Center for Health Statistics reports that 7.5 percent of U.S. children between ages 6 and 17 were taking medication for “emotional or behavioral difficulties” in 2011-2012.2

The CDC reports a five-fold increase in the number of children under 18 on psychostimulants from 1988-1994 to 2007–2010, with the most recent rate of 4.2 percent.3

The same report estimates that 1.3 percent of children are on antidepressants.

The rate of antipsychotic prescriptions for children has increased six-fold over this same period, according to a study of office visits within the National Ambulatory Medical Care Survey.4

In children under age 5, psychotropic prescription rates peaked at 1.45 percent in 2002-2005 and declined to 1.00 percent from 2006-2009.5

Taken together, what do these numbers mean? A common interpretation: children with behavioral or emotional problems are being overmedicated by psychiatrists too busy to provide therapy, at the request of parents too busy to provide a healthy home environment. A corollary of this interpretation is to blame schools too busy to provide recess or activities for fidgety boys. And usually the blame extends to the pharmaceutical companies that market medications in pursuit of profits.

While blaming psychiatrists, parents, schools, or drug companies might seem legitimate, some of the facts just don’t fit. First, most of the prescriptions for stimulant drugs and antidepressants are not from psychiatrists.6 In fact, outside of a few major cities, families in much of the nation have very limited access to child psychiatrists. Blaming parents is easy, but as Judith Warner argues in her book, We’ve Got Issues, most parents resist medication rather than request it.7 Schools in many parts of the country have reduced unstructured time, but the increase in medication is now seen in toddlers, years before children begin school. And drug companies, while frequently maligned, have reduced, not increased, their marketing budgets in the US.8

If psychiatrists, parents, schools, or drug companies are not the culprit, who is? The answer is potentially more complicated and more worrisome. Is it possible that the increased use of medication is not the problem but a symptom? What if more children were struggling with severe psychiatric problems and actually the problem was not over-treatment but increased need? Surely, if we discovered more children were being treated for diabetes or immune problems, we wouldn’t blame the providers or the parents. We’d be asking what drives the increase in incidence. And, there actually are large increases in the incidence of Type I diabetes and food allergies.9,10,11

Full article at Link

————————

Further Readings of Interest

Prevalence of Allergic Disease in Foreign-Born American Children

http://archpedi.jamanetwork.com/article.aspx?articleid=1681064

Autistic-like behavioural and neurochemical changes in a mouse model of food allergy.

http://www.ncbi.nlm.nih.gov/pubmed/24333575

Comorbidity of allergic and autoimmune diseases in patients with autism spectrum disorder: A nationwide population-based study

http://www.sciencedirect.com/science/article/pii/S1750946712001018

 

Advertisements
This entry was posted in Allergy, Asthma, Autism, co-morbid, Depression, diabetes, Environment, Epidemiology, Gut, Immune System, Inflammation, Neurology, Physiology, Schizophrenia, Treatment. Bookmark the permalink.

3 Responses to Tom Insel – NIMH – Are Children Overmedicated ?

  1. RachellieBellie says:

    Permission to reblog?

  2. RachellieBellie says:

    Reblogged this on My Puzzling Piece: A Glance Into A Puzzling Existance and commented:
    An interesting article from the ASD Research Initiative about the statistics behind medicating our kiddos. Thank you, ASD Research Initiative.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s