Antidepressant Use in Children Soars Despite Efficacy Doubts

The Washington Post ^ | April 18, 2004 | Shankar Vedantam

[neverdem]

The number of depressed American children being treated with antidepressants has soared over the past decade -- a tectonic shift in the practice of psychiatry -- but new scientific reviews of the research that fueled the trend suggest that the drugs' benefits have been dramatically oversold.

The use of antidepressants among children grew three- to tenfold between 1987 and 1996, data from various studies indicate, and a newer survey found a further 50 percent rise in prescriptions between 1998 and 2002. The explosion in antidepressant use occurred even though the vast majority of clinical trials have failed to prove that the medicines help depressed children.

The spike in prescriptions over the past five years has been especially sharp among children younger than 6, even though there is virtually no clinical trial data on these youngest patients.

[RockyMtnMan]

Nevermind that some children actually enjoy going to daycare where they can play with friends and outdoor toys unavailable at home. Blame the parents for keeping their children in a care center that their child loaths going to and has little educational benefit for the child.

[Lizavetta]

But don't take them out of 60-hour-a-week daycare and let them be normal children or anything ... that would inconvenience the parents!

That's right, and whatever you do don't say anything about the divorce rate.

[Eska]

I've seen both sides of the picture in the classroom. Alot of kids benefit from the medication.

What really bothers me is all the abuse situations in the American family. I have several emotionally disturbed students; all the kids were sexually abused by parents and now are being raised by relatives. Without medication these children will be institutionalized. Pretty sad, because these kids are very intelligent and driven individuals. For these type kids, the medication is very necessary. Also, why doesn't our govt hold abusive parents accountable? They slap their hands and the kids are destroyed for the rest of their lives.

[Steve Eisenberg]

What about this study? Also this one?

With the trycyclic antipressants, just about all the studies showed weight gain. With the SSRI's, some of the studies go one way (as in your links), others go the other, and some show no differences. Also, a lot of these poor kids are probable taking Ritilin, Adderal, Buspar and/or Wellbutrin on top of their SSRI, radically changing the picture.

One thing to keep in mind is that weight loss is a depression symptom. Some of the kids getting the SSRI are too thin, so weight gain can be a good thing. To be meaningful, studies have to take into account the whole clinical picture including what the person's weight trend way before starting to take the drug.

Looking at the bottom half of this link one can see some of this:

Antidepressant Medications

Again, I'm not saying that it's good for lots of kids to be on all these drugs. Also, I'm not saying that the article by Drs. Sussman and Ginsburg is bad. I think they did a nice job even though their article is not the last word by any means. I also think that the good doctors would agree with me that the older tricyclic antidepressants were more associated with obesity. So even if Sussan and Ginsburg are right, which is far from proven, this would not in the least explain the epidemic of childhood obesity.

[rockrr]

OK. Here's my story:

My ex divorced me ten years ago when our daughter was one. Washington state favors awarding the female custody of the children UNLESS you are extremely wealthy, or the female is extremely f'd up. So my daughter goes with her mom.

Nine years later my ex is so self-absorbed that she virtually ignores her little girl. Now the school steps in with constant, subtle entreaties to the kids that the can "feel free to confide in the counselors". "They're here to help you". So my daughter relates how miserable her home life is. The school counselor dogmatically reports her findings to a district psychiatrist who starts the "Prozac Express" (actually, what she prescribed was Zoloft). I met with all of the principles and attempted to refocus on the systemic problem - her home life - all without any measurable success. The "professionals" wanted to pat me on the touchie and send me on my way: "I can assure you, Mr. Rockrr, that there are ALMOST no negative effects from the use of these psychotropic drugs".
The mother was reluctant at first to go with the treatment, but eventually folded (she could see the merit in a compliant child), leaving me to defend my daughter's health and well-being.

Things got to the point where a COURT ORDER was bandied about, when the most curious thing happened. My ex, gainfully employed and properly insured, had been suggesting to the school system that she was poverty-bound and in need of special services. The State of Washington came to me to pay the tab and, in their inimitable fashion, harassed me until I PROVED that my ex was subverting the system (of course she suffered no recriminations whatsoever). But, in the intervening time, the state chose to withhold services to my daughter. Services which amounted to force-feeding psychotropic, ADDICTIVE drugs to my child, against the express wishes of her parent. My daughter dodged a bullet because the state was now focused on punishing ME!

I place the weight of responsibility for the overuse and inordinate prescription of these drugs on the most innocent of victims squarely one the "mental Health Professionals".

A pox on them.

[genghis]

what do you expect?
The emphasis on "feeelings" leads to this. As soon as we get back to the emphasizing achievement, and not focusing on "how the child feeels", some of this craziness will go away.
Thios is so wrong on so many levels.
It teaches the child that doctors have power, but the child doesn't.
It teaches the child if you don't feel good, take some pills. Tis can't be good for preventing future drug endeavers.
To treat depression do the following
1- strech (especially in the morning)
2- slow deep breathes
3- exercise ( most important)
It is almost physiologically impossible to be depressed if you exercise enough.
4- eat meat
4b- eat small portions of chocolate
5- make friends
5- set small achieveable goals and take steps to achieve them
6- do something to help others
7- go to church
do not see a psychiatrist or take pills.

[Wolfie]

I especially like the ads that give you no clue as to what the drug is actually supposed to do for you.

I always wondered about that myself. Turns out the Feds require that if the commercial tells you what the drug does, then they also have to list the vast array of side effects that are possible.

[Ready4Freddy]

What is up with that? Some may give you a hint (old folks moving slowly = arthritis med :), but many leave you wondering. I can see me calling my doc - Freddy: "Hey, Doc, would xyz med help me?" Doc: "Only if you're a postmenopausal transvestite, Freddy".....

"I especially like the ads that give you no clue as to what the drug is actually supposed to do for you."

[Ready4Freddy]

Thx, was wondering about that, figured the FDA was involved somehow.

[jocon307]

"...if the commercial tells you what the drug does, then they also have to list the vast array of side effects that are possible."

Ah ha! That does explain it. There was some radio ad running a couple of years ago, it might have been for Olestra, and not for a drug, but in any event the list of side effects was absolutely stomach turning. It didn't last too long.

[Prime Choice]

Pills are not the answer.

Agreed. Drugs that help the body fight off infections are one thing. Drugs that alter the mind...that's another ball of wax entirely.

I prefer old-fashioned non-drug "treatment."

Hyperactive? Yardwork and joining the track team will fix that. And no more sweets for you, buster.

Depressed? Talk it out. God made friends. Man made Prozac. Know the difference.

Anxious? See above.

Aggressive? Welcome to the football team. Here you'll learn what real aggressiveness is...and what it's like to be the receiver of it.

[Prime Choice]

And don't forget this piece of age-old wisdom:

"There is no psychiatrist in the world like a puppy licking your face."

: )

[neverdem]

Antidepressant Use in Children Soars Despite Efficacy Doubts

My apologies for a bum link. My computer crashed yesterday. It was real slow lately, and in my attempts to fix it, it crashed and burned. I couldn't even open Windows, let alone go online. I'm not sure that I'm out of the woods yet.

[kcar]

I gotta believe that one day the gun-grabbers will define anyone who has ever been on anti-depressants or Ritalan as unfit to own a gun. That would explain why they're planting the seeds today.

[RipSawyer]

"I place the weight of responsibility for the overuse and inordinate prescription of these drugs on the most innocent of victims squarely one the "mental Health Professionals"."

Based on my limited experience, I believe that the least likely place to find actual mental health is among "mental health professionals".

[RipSawyer]

Very good advice you are offering. Please read my post no. 35.

[neverdem]

I gotta believe that one day the gun-grabbers will define anyone who has ever been on anti-depressants or Ritalan as unfit to own a gun. That would explain why they're planting the seeds today.

That's a sure bet. With all these electronic medical records being generated, don't be surprised with the exceptions to privacy that will be made. I believe that in one or more states that were debating the right to concealed carry of handguns, that a DUI was a proposed disqualification, as well as misdemeanor possession of drugs, no matter how long ago, IIRC.

[cyborg]

Good friends give better advice than dopey pill pushing shrinks. I have a very low opinion of the psychiatric profession on the whole. I'm doing things on your list and they are infinately better and cheaper than shrinks and pills.

[Choose Ye This Day]

It's a hilarious song by newcomer Gretchen Wilson. Here are the lyrics:

"Redneck Woman"

Well, I ain't never been the Barbie doll type
No, I can't swig that sweet Champagne, I'd rather drink beer all night
In a tavern or in a honky tonk or on a four-wheel drive tailgate
I've got posters on my wall of Skynyrd, Kid and Strait
Some people look down on me, but I don't give a rip
I'll stand barefooted in my own front yard with a baby on my hip

'Cause I'm a redneck woman
I ain't no high class broad
I'm just a product of my raising
I say, 'hey ya'll' and 'yee-haw'
And I keep my Christmas lights on
On my front porch all year long
And I know all the words to every Charlie Daniels song
So here's to all my sisters out there keeping it country
Let me get a big 'hell yeah' from the redneck girls like me, hell yeah

Victoria's Secret, well their stuff's real nice
But I can buy the same damn thing on a Wal-Mart shelf half price
And still look sexy, just as sexy as those models on TV
I don't need no designer tag to make my man want me
Well, you might think I'm trashy, a little too hardcore
But in my neck of the woods I'm just the girl next door

I'm a redneck woman
I ain't no high class broad
I'm just a product of my raising
I say, 'hey y'all' and 'yee-haw'
And I keep my Christmas lights on
On my front porch all year long
And I know all the words to every Tanya Tucker song
So here's to all my sisters out there keeping it country
Let me get a big 'hell yeah' from the redneck girls like me, hell yeah

I'm a redneck woman
I ain't no high class broad
I'm just a product of my raising
I say, 'hey y'all' and 'yee-haw'
And I keep my Christmas lights on
On my front porch all year long
And I know all the words to every ol' Bocephus song
So here's to all my sisters out there keeping it country
Let me get a big 'hell yeah' from the redneck girls like me, hell yeah
Hell yeah, hell yeah
Hell yeah
I said hell yeah!

[Tax-chick]

Thanks for the lyrics! I actually prefer champagne (or good old pink Gallo) to beer, but I've spent many afternoons out front in bare feet, with a baby or two or three ... Hell yeah!