Pubdate: Tue, 22 Feb 2000
Source: Associated Press
Copyright: 2000 Associated Press
Author: Lindsey Tanner


CHICAGO (AP) -- When he was a toddler, Heath Barker was nicknamed "the red
tornado" for his auburn hair and his penchant for tearing things up and
jumping off the furniture. When he was just 4, he was diagnosed with
attention deficit disorder and prescribed Ritalin.

A study of more than 200,000 preschool-age children shows this was no
isolated case.

The number of 2- to 4-year-olds on psychiatric drugs including Ritalin and
anti-depressants like Prozac soared 50 percent between 1991 and 1995,
researchers reported in Wednesday's Journal of the American Medical

Experts said they are troubled by the findings, because the effects of such
drugs in children so young are largely unknown. Some doctors worry that
such powerful drugs could be dangerous for children's development.

Heath's mother has anecdotal evidence suggesting -- as the researchers do
- -- that the number of youngsters on psychiatric drugs is still rising.
Through her involvement in Internet support groups for parents of children
with behavior problems, Michele Barker said she is hearing of more and more
3- and 4-year-olds being put on drugs like Prozac.

"It's become a quick fix," said Barker, 39, of Hot Springs, Arkansas.

Although the study did not examine reasons for the increases, Julie Magno
Zito, the lead author and an assistant professor of pharmacy and medicine
at the University of Maryland, suggested a few possibilities.

With an increasing number of children attending day care, parents may feel
pressured "to have their children conform in their behavior," Zito said.
She also said there is a much greater acceptance in the 1990s of
psychoactive drugs.

Dr. Joseph T. Coyle of Harvard Medical School's psychiatry department said
the study reveals a troubling trend, "given that there is no empirical
evidence to support psychotropic drug treatment in very young children and
that there are valid concerns that such treatment could have deleterious
effects on the developing brain."

"These disturbing prescription practices suggest a growing crisis in mental
health services to children and demand more thorough investigation," Coyle
wrote in an editorial accompanying the study.

The authors reviewed Medicaid prescription records from 1991, 1993 and 1995
for preschoolers from a Midwestern state and a mid-Atlantic state; and for
those in an HMO in the Northwest. The states were not identified.

Use of stimulants, anti-depressants, anti-psychotics and clonidine -- a
drug used in adults to treat high blood pressure and increasingly for
insomnia in hyperactive children -- were examined. Substantial increases
were seen in every category except anti-psychotics, though in some cases
the actual number of prescriptions was quite small.

The number of children getting any of the drugs totaled about 100,000 in
1991, and jumped 50 percent to 150,000 in 1995. That year, 60 percent of
the youngsters on drugs were age 4, 30 percent were 3 and 10 percent were

The use of clonidine skyrocketed in all three groups. Although the numbers
were small, the researchers said the clonidine increases were particularly
remarkable because its use for attention disorders is "new and largely
uncharted." They noted that slowed heart beat and fainting have been
reported in children who use clonidine with other medications for attention

Dr. David Fassler, chairman of the American Psychiatric Association's
council on adolescents and their families, said the medications studied
"can be extremely helpful for some children, even quite young children."
But they should be prescribed only after a comprehensive evaluation and in
conjunction with other therapy, he said.

Their use is increasing in part because doctors are getting better at
diagnosing behavior disorders at an early age, Fassler said.

However, because their effects on younger children and their development
aren't known, Fassler said, the Food and Drug Administration has recently
instructed pharmaceutical companies to study the connection.

Barker said Ritalin calmed her son and helped him do well in school. But it
also stole his bubbly personality, so she took him off it after four years.

"He started becoming the so-called zombie," she said. The family altered
his diet and tried nutritional supplements instead.

Now almost 12 and drug-free for nearly four years, Heath is repeating fifth
grade and has some learning difficulties. But his mother said he seems
happier, and so is she.

"I don't care if he's not an honor roll student," she said, "because he's
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