An American Phenomenon: The Widespread Psychiatric Drugging of Infants and Toddlers

The United States has become the psychiatric drugging capital of the world for kids with children being medicated at a younger and younger age. Medicaid records in some states show infants less than a year old on drugs for mental disorders.

The use of powerful antipsychotics with privately insured children, aged 2 through 5 in the US, doubled between 1999 and 2007, according to a study of data on more than one million children with private health insurance in the January, 2010, "Journal of the American Academy of Child & Adolescent Psychiatry."

The number of children in this age group diagnosed with bipolar disorder also doubled over the last decade, Reuters reported.

Of antipsychotic-treated children in the 2007 study sample, the most common diagnoses were pervasive developmental disorder or mental retardation (28.2%), ADHD (23.7%), and disruptive behavior disorder (12.9%).

The study reported that fewer than half of drug treated children received a mental health assessment (40.8%), a psychotherapy visit (41.4%), or a visit with a psychiatrist (42.6%) during the year of antipsychotic use.

"Antipsychotics, which are being widely and irresponsibly prescribed for American children--mostly as chemical restraints--are shown to be causing irreparable harm," warned Vera Hassner Sharav, president of the Alliance for Human Research Protection, in a February 26, 2010 InfoMail.

"These drugs have measurable severe hazardous effects on vital biological systems, including: cardiovascular adverse effects that result in shortening lives; metabolic adverse effects that induce diabetes and the metabolic syndrome," she wrote. "Long-term use of antipsychotics has been shown to result in metabolic syndrome in 40% to 50% of patients."

The lead researcher on the study above, Columbia University psychiatry professor Mark Olfson, told Reuters that about 1.5% of all privately insured children between the ages of 2 and 5, or one in 70, received some type of psychiatric drug in 2007, be it an antipsychotic, a mood stabilizer, a stimulant or an antidepressant.

Psychiatric drugs bathe the brains of growing children with agents that threaten the normal development of the brain, according to Dr Peter Breggin, founder of the International Center for the Study of Psychiatry and Psychology (ICSPP), and author of about 20 books, including "Medication Madness."

The drugs themselves are causing severe disorders in millions of children in the US, he warns. "Substances like antidepressants, stimulants, mood stabilizers, and antipsychotic drugs  cause severe, and potentially permanent, biochemical imbalances."

American Phenomenon

A number of presentations at the annual meeting of the American Psychiatric Association in May 2009, addressed the diagnosis of bipolar disorder, including one titled, "Pediatric Bipolar Disorder: A Critical Look at an American Phenomenon," at which Dr Peter Parry, a consultant child & adolescent psychiatrist, and senior lecturer at Flinders University in Australia, presented a survey on, "Australian and New Zealand's Child and Adolescent Psychiatrists' Views on Bipolar Disorder Prevalence and on Rates of Pediatric Bipolar Disorder in the USA."

Dr Parry and his colleagues conducted a survey of child and adolescent psychiatrists in Australia and New Zealand. Of the 199 psychiatrists who responded to the survey, 90.5% thought pediatric bipolar disorder was overdiagnosed in the US.

In an October 1, 2009 article titled, "Medicating Our Children," Dr Parry reports that since "the mid-1990s in the USA, some researchers have claimed that Paediatric Bipolar Disorder (PBD) frequently starts prior to puberty."

One of PBD's main proponents, Harvard University's Professor Joseph Biederman, stating onset "is squarely in the preschooler age group," he notes.

Parry explains that "PBD has been created by moving the diagnostic goalposts away from traditional concepts of bipolar disorder."

"In children," he says, "episodes were redefined to last hours instead of days or weeks and, instead of manic elation, severe anger in children sufficed as mania."

"Unlike diagnoses like ADHD or depression, or simply accepting a child has serious emotional and behavioural problems in reaction to various stressors, PBD implies a lifelong severe mental illness requiring of strong psychiatric medication," Parry warns.

"In the USA," he says, "the public is furthermore exposed to direct pharmaceutical advertising that can feed the natural desire parents of distressed and aggressive children have for a quick solution by suggesting a simple medication fix."

"The medicating of America's children has become intensely controversial, highlighted by the tragic case of Rebecca Riley, a four-year-old Boston girl diagnosed at 28 months old with ADHD and PBD," he points out.

On April 7, 2009, the author of the book, "Shyness: How Normal Behavior Became a Sickness," Christopher Lane, featured an interview on his Psychology Today blog, "Side Effects," with journalist, Philip Dawdy, the creator of the popular website, Furious Seasons, and discussed the rising number of children being diagnosed with bipolar disorder.

"As for bipolar disorder in kids (meaning pre-teens and younger), it's simply not an issue in the rest of the world," Dawdy told Lane. "The bipolar child is a purely American phenomenon."

"The pharma companies and the Harvard crew worked hand-in-hand to bring America a generation of ADHD kids and bipolar children, and their profound influence can be seen in the millions of children and teens who now carry lifetime diagnoses and take gobs of psychotropic drugs each day, often to their detriment," he advised.

Lane asked for Dawdy's opinion on a recent report in the St Petersburg Times that found 23 infants less than one-year-old had been prescribed antipsychotics in Florida in 2007, as well as the drug overdose death of 4-year-old Rebecca Riley in Massachusetts. "How is it possible for psychiatrists to continue prescribing to infants in such numbers without more oversight?" Lane asked.

"What's gone on with antipsychotics prescribed to infants and toddlers is simply inexplicable to me," Dawdy said. "The drugs are known to cause huge problems in adults, so why the heck would a doctor give them to little kids, especially infants? It boggles my small mind."

"I'm no fan of bans or restrictions," he told Lane, "but this does strike me as a situation where there needs to be a serious rethinking of what we are doing—and maybe there should be a ban on the use of these drugs in kids under, say, 6 years of age."

An October 2007 report by the University of South Florida found the most common diagnosis for antipsychotic use with children in Florida’s Medicaid program, between July and December 2005, was ADHD. Roughly 54%, or 1,372 cases, involved prescriptions for children five and under and the total number of antipsychotic users in this young age group was 2,549, with all disorders combined, according to the report.

Increased Prescribing to Poor Children

Federally funded research published online in December, 2009, revealed that children covered by Medicaid were prescribed antipsychotics at a rate four time higher than children with private insurance. The data showed that more than 4% of children in Medicaid fee-for-service programs received antipsychotics, compared to less than 1% of privately insured youth. The study found Medicaid kids were more likely to receive antipsychotics for unapproved uses such as ADHD and conduct disorders than privately insured children.

The researchers examined records for children in seven states for the years 2001 and 2004, chosen as representative of the US Medicaid population. But more recent data through 2007 indicates that the disparity has remained, said Stephen Crystal, a Rutgers professor who led the study, according to the December 11, 2009, New York Times.

Antipsychotics were the top selling class of drugs in both 2008 and 2009. With sales of $14.6 billion in 2009, they brought in more than the $13.6 billion earned by both heart burn and cholesterol medications. Antidepressants ranked fourth with sales of $9.9 billion, according to data by IMS Health. In 2008, the drug makers took in $11.3 billion from antiseizure drugs and $4.8 billion from ADHD drugs.

In a new book titled, "Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America," Robert Whitaker reports that the number of children on government disability rolls due to severe mental illness has increased more than 35-fold since 1987.

The book explores the question of whether the epidemic rise in people disabled by mental illness, among all age groups in the US over the past 20 years, could have been fueled by a drug-based paradigm of care.

It also explores what is happening to children over the long-term who are placed on psychiatric drugs. "Once again, science tells a very clear story, and, as you might imagine, it is one that — when you think of the millions of children so affected — makes you want to weep," Whitaker stated in a March 26, 2010, notice for the book's release on the Beyond Meds Website.