The use of psychotropic prescription medications to treat mental health disorders in very young children is stabilizing, according to a study published in the journal Pediatrics.
Psychotropic medications that are commonly prescribed to treat ADHD, mood disorders and other mental health problems include both typical and atypical antipsychotics, antidepressants, antianxiety agents, stimulants and mood stabilizers.
Few of these medications have been approved for use at preschool age by the US Food and Drug Administration (FDA).
However, the researchers from the Cincinnati Children’s Hospital Medical Center say previous studies have shown that psychotropic prescriptions increased two to threefold for preschool children between 1991 and 2001.
For their study, the researchers reviewed two national surveys of children aged between 2 and 5-years-old to determine the use of psychotropic prescription medications in these age groups between 1994 and 2009.
The surveys collected information on 43,000 young patients who visited office-based physician practices and hospital-based outpatient clinics throughout the US.
Results of the analysis revealed that overall, psychotropic prescription use peaked between 2002-05 but leveled off between 2006-09.
When looking at children who were diagnosed with one or more behavioral diagnoses, psychotropic usage decreased from 43% between 1994-97, to 29% between 2006-09.
However, the review showed increased psychotropic medication usage among boys, white children and those without private health insurance over the study period.
The researchers say that as numerous warnings regarding the use of psychotropic medications were issued in the mid- to late 2000s, this may have caused usage to level off during this period.
In 2004, the FDA issued a “black box” warning linking psychotropic medications to suicide risk.
In 2005, amphetamines were linked to cardiovascular risk, sparking a public health warning, while 2006 saw an FDA Advisory Committee recommendation for a black box warning (which was later reversed) on psychostimulants, after the drugs were linked to heart problems.
Dr. Tanya Froehlich, pediatrician at Cincinnati Children’s Hospital Medical Center and senior study author, says that their findings emphasize the need to ensure that doctors are careful when prescribing psychotropic medication to preschool-age children:
“Our findings underscore the need to ensure doctors of very young children who are diagnosing ADHD, the most common diagnosis, and prescribing stimulants, the most common psychotropic medications, are using the most up-to-date and stringent diagnostic criteria and clinical practice guidelines.”
“Furthermore,” she adds, “given the continued use of psychotropic medications in very young children and concerns regarding their effects on the developing brain, future studies on the long-term effects of psychotropic medication use in this age group are essential.”
The authors note that further research is also needed to understand why boys, white children and those without private health insurance are more likely to be prescribed these medications, and whether these prescriptions are appropriate.
In 2011, Medical News Today reported on a US Government Accountability Report showing that foster children are being prescribed psychotropic medication at doses beyond what the FDA approved.