Stimulant Use by Children on Rise
By Sally Finlay
Originally published in The Age, August 21, 2000
Parental pressure and inadequate health services have led to an increase in the prescription of potentially dangerous psychotropic drugs for children under five, mental health experts have warned.
The latest Medical Journal of Australia says that while Australia-wide figures are unavailable, overseas trends and the experience of local doctors indicate the use of stimulants is growing.
In the past decade the number of pre-school children treated with stimulants in New South Wales has risen twelve fold.
In that state almost 6000 children under six who had been diagnosed with attention deficit disorder were treated with a psychotropic drug between 1990 and 1999.
Psychotropic drugs affect the psychic functions, behavior or experience of a person using them. Stimulants, anti-depressants and anti-psychotics are all classed as psychotropic drugs—generally prescribed for attention deficit disorder, depression and schizophrenia.
Child and adolescent mental health experts, Professor Joseph Rey, Professor Philip Hazell and Gary Walter have raised concerns over the use of the drugs in the journal's editorial, and have called for greater research into the effects of anti-depressants and anti-psychotics on children.
The journal's report says that the effects of psychotropic drugs have been studied on adults. Physicians only assume they will be safe and effective for the young.
"There is no evidence about the effect of these drugs on children aged under four years," says Professor Rey.
"The Therapeutic Goods Administration should require pharmaceutical companies to provide at least safety information for these drugs (in children) like in the United States."
The report cites Clonidine, a drug used to treat high blood pressure in adults, which is increasingly being used to treat behavior problems in children and has led to poisoning or overdose incidents. Long-term effects of psychotropic drug use on children remain unknown, but the report warns there is sufficient cause for concern.
Despite a lack of research into their effects, doctors are continuing to prescribe psychotropic drugs for children in response to pressure from parents and schools, the report says.
Professor Rey says psychiatric diagnoses in preschoolers lack validity and drugs are all too often an "easy way out" for parents and practitioners. The editorial says that doctors are treating greater numbers of children with severe behavior problems in a health system with inadequate mental health services for young people.
"Clinicians find themselves in an all-too-familiar predicament: urged to prescribe but having no evidence base for doing so," the report says.
Professor Rey and his colleagues have called on the National Health and Medical Research Council to confront the difficult ethical issue of drug testing on children and to give priority to research on the treatment of children with psychotropic medication.
