Psychiatric medications for small children

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This is an extremely tragic story of a 4-year-old who died from an overdose of her prescribed psychiatric medications:
here

You'll find much disagreement among those interviewed for the story about whether the parents were administering the medication as directed or not, and whether they could have prevented the child's death by seeking treatment for her overdose symptoms. That will be a subject for a criminal jury to decide.

My question for those interested: do you think we are over-prescribing powerful psychiatric medication for children? Is this a common practice in other countries besides the U.S.?

On the one hand, a child might be helped immeasurably by having a serious medical problem treated early. On the other hand, the ups and downs of childhood are just that, not a problem needing treatment.

Just interested in your thoughts.

 

I abhor the current practice of drugging children. Don't get me wrong, there are a few schizos out there---but they are few and far between.

I think adults demand their childrens' lives to be entirely too structured and scheduled. Kids want to talk and share about what they like, not be instructed to believe in the teacher's version of the world... Many kids just can't conform themselves to the brainwashing they are expected to view as a 'goal'.

You have no idea how much I hated school as a child...

When I have kids, it is going to be home-schooling or alternative schooling. I want my kids to spend at least half of the 'structured' part of their day doing something completely impractical---things like dancing, drawing, playing music, and just running around in the woods.

 

I have talked with my father, a practicing clinical psychologist, on this many times and he says it is incredibly hard, and innacurate, to diagnose a child with most any mental disorder. This is especially true of organic disorders like ADHD ro schizophrenia. At this point in the child's life, the brain is incredibly maleable, and I'm talking about the brain, not just the mind. It can change in drastic ways to adapt to a changing environment. Many psychologists and psychiatrists are lothe to treat children at all for anything but the most extreme problems (PTSD, child abuse, etc.) because it is quite possible the brain and mind can fix themselves, and medicating the child would make the brain 'fix' itself for an environment that included those medications, meaning the child would need them for the rest of their lives.

On top of that, the symptoms that, in an adult, point to ADHD and Bi-polar disorder are symptoms of the natural metabolic rates for children. When i was 3, I would run around the house like a mad thing for an hour or more, and then suddenly plop face down on the floor and fall asleep. That's natural for children, they're supposed to be like that, but in an adult, that's a serious problem, and a symptom of Bi-polar disorder. Distractability and hyper-activity are also natural in children, but in adults that's called ADHD. These conditions are 'diagnosed' in children FAR FAR to often, just because the parents don't want to deal with energetic kids, and the psychiatrist who diagnoses and medicates wants to make a quick buck. Its sickening, its immoral, and its probably VERY dangerous and damaging to the kids involved.

 

My wife is a school teacher, and she tells me that in a typical class of 25 kids, about 5 of them are on medication for ADHD. I have a very hard time accepting that about 20% of all children have ADHD, considering NO ONE I knew when I was growing up had ADHD, and me and all of my friends turned out fine.

So on one hand, I do think we may be over-medicating children. On the other hand, I also believe that if you follow the instructions of how to administer the medication to your kids, then it should be safe to take the medication.

 

I don't know about other countries but I do think that here in the USA there is a strong tendency to think that pills solve everything.

The parents in this article seem to have a lot of problems of their own and the System just wasn't there for this child. I find it scary that there may be a lot more children at risk.

 

I would never medicate my own children if they had ADHD, the medication is next to useless, and is incredibly harmful in the longrun. I would just take them to a nutritionist. Patrick Holford, and many other nutritionists have done studies which prove that just changing a childs diet is far more effective than medicating them with Ritalin and such like.

That's because most of the people in power have shares in large drug companies.

 

It is also because the average person, due to the dawn of the Age of Information (tm), has a wealth of knowledge at their beck and call which they are not fully capable of understanding.

I don't know the statistics, but I would guess there has been a massive growth in obsessive-compulsive disorders over the last ten years or so. I live in an off-campus housing facility outside of a university---there are a lot of people here, so I get a chance to see a wide swath; you would not believe the percentage of half-bright germophobes there are amongst people in their early twenties. It has to be at least one out of seven or so. It is kind of scary.

The human immune system needs a commercial on TV.

 

That would actually work really well. I don't know about the rest of the world, but America has developed a germaphobic ideology. 'If you don't wipe your counter with anti-bacterial wipes every 12 hours, you may be exposing your kids to dangerous bacteria!' What a load of bull. Kids who play in the dirt and grime on a regular basis are less likely to get sick later in life, much less likely. On top of that, heavy use of such antibacterial agents leads to resistant bacteria.

 

That is very true NOG. I remember seeing a study on PBS warning about the over-use of antibacterial agents. Bacteria can adapt a lot faster than we can.

 

Uh, no. Sorry.

Without suggesting that nutrition doesn't have A LOT to do with behavior, or that changing a child's diet shouldn't be tried as part of a behavior modification plan, I have to disagree with that blanket condemnation of meds. When used in the proper conditions on the proper patient, meds like Ritalin are incredibly helpful. The long-term effects of allowing a genuine diagnosis of ADHD to go untreated are terrible: it can lead to a death spiral of poor achievement and low self-esteem and decreased expectations. It's not right to condemn a child to perpetual failure when something can be done.

Note that I'm not coming from a theoretical standpoint here, I'm watching this happen. My son and at least one of his friends are considered at-risk for ADHD. Fortunately Arlyn is managing to achieve good academic results while he works to control his behavior, but the other boy isn't so lucky. ADHD is often part of a package of learning disabilities, and if it takes meds to get it under control so the other issues can be addressed then I'm glad the meds are there.

No potential solution should be dismissed out-of-hand, but they all should be prioritized according to risk and tried in order. IMO, meds are the last resort, not the first.

 

I think I agree with that, Rallymama. I do wonder if you can really tell that a preschooler needs to be treated with medication for psychiatric disorders. But all my own experience has been with adults, and I have no children of my own, though I do have a niece (now in middle school) being treated for ADHD, with mixed success.

Even with adults, I have learned, psychiatric drugs are no cure-all. For anti-depressant drugs, for instance, even the drug companies don't claim they help more than 70% of people who take them - and the word is help, not cure. Those who have their symptoms disappear are a much lower percentage than that, even. One study I read recently showed that more than 30% of people were not even helped by anti-depressants even after two different medications were tried. So while it's worth trying them, don't be astonished if they don't work - they don't, for a large minority of patients. And the information for how they work in children is almost non-existent.

I agree that the parents in this story were not in good shape themselves, if the story reports their situation accurately. I always hesitate to swallow whole the media description of "bad" parents, because it is such a sensational topic.

But it does seem indisputable that we have a dead child, and that she died from an overdose of very strong prescriprion medications. No matter how you look at the rest of the story, this is a great tragedy.

 

Long term effects.

 

@Sarevok: I know what you meant, and I still disagree with you.

 

Rally, of course I do not know your situation, but I will speak of my own experience. What is 'normal'? Normal to whom? There are many people that considered me abnormal as a child: my parents, the man whom decided what the 'standard' is of standardized testing (go IQ!---'cause that means I'm 'smart'... ), and plenty of my teachers... Rather than have anyone tell me that it was OK to behave significantly differently from the other children, I was instead given chemicals so that I would comform to what THEY wanted me to be. And then one of those drugs turned out to cause long-term liver damage... Now I don't know for certain that my liver has actually been damaged...but it may have been...maybe I'll find out one day when something goes horribly wrong---and then I'll have the privilage of sueing a drug company, because all that money will certainly make me happy again...

The thing about drugs is that they turn everyone into the same person. All potheads have the same sort of sedentary forgetfullness. Alcohol does effect different people in different ways, but in actuality, there are really only like five different kinds of drunks (I'm the really talkative kind...but I quit drinking anyway...). That is what drugs do: tone down everyones individuality until they are all the same sort of sub-grade conformists (whom believe they are happy because they all tell each other so...never mind how they actually feel inside...).

Let me ask you this: Will your child's grades at school determine whether he has a good life? Will him growing up knowing that his mother (whom is a very smart woman) 'knows' there is something 'wrong' with WHO HE IS help or hinder him in having a good life?

Just my two cents...

 

@LNT: The thinking with my son's teacher is that he needs to get his behavior under control - keeping his hands to himself, not calling out, sitting still, focusing on his work, not disrupting others, etc. We don't think that there's anything 'wrong' with him, just that he needs some extra help at mastering this particular set of necessary social skills. The approach is to use a series of exercises and goals to help him learn how to do this on his own. Only if these exercises don't work and all involved - including the school counsellor and his pediatrician - become convinced that his behavior is genuinely beyond his control will medication be considered. As far as I know, that's the common approach these days.

The thing with medication is that any foreign substance introduced into the body has the possiility of causing damage. There's reason that drug commerecials have a long list of possible side effects - they're the adverse events that were experienced during clinical trials. Some of the effects are trivial, some not, but they all have to be reported. It's up to the individual to determine if the chance of experiencing a side effect is too much of a price to pay for relief from the existing condition and its future impacts.

 

All though I am basically anti-drug I do believe there are times when it is necessary. Now I do not claim to be an expert on the subject but I have known children (a very few) who were a danger to themselves and others. They did need medication to control their behavior. The parents were concerned, caring, intelligent, well educated people and didn't medicate them casually or thoughtlessly.

As Rally has stated:

Each child (person) must be an individual case by case study. This is true not only for ADHD medication but any medication including aspirin or any over-the-counter medication. Even vitamins.

 

When? Why do they have to be mastered right now? Who has made the schedule? Has the schedule been made by someone that loves him?

Childhood is about being insulated from the consequences of your actions by the love of the more powerful. Be that insulation. He'll have a whole life to figure out how to make himself happy---not talking out of turn, and not pulling the hair of others, and all the other behaviors which have negative consequences will have long ago been figured out. Having a different pace of growth than other people is, you know, entirely human.

 

You know, I fully agree with this statement. The thing is, every family is going to have a different definition of "insulation" and different expectations of what is "right" child behavior. If Hubby and I - the people who love Arlyn most in all the world! - didn't agree that he needs help in learning some basic impulse control, there wouldn't be an issue.

The other thing that childhood is for, is establishing the foundation for the rest of your life. It's easier for children to learn than for adults. We are of the mind that if we don't start working with Arlyn to help him develop good self control NOW, it's going to be much harder for everyone later.

Life's full of choices, and that's mine in this regard. To get back on-topic, I hope and pray that it never comes to him needing medication, although my nephew was greatly helped by Ritalin. I think Arlyn is showing enough progressto avoid it; some of his friends, I'm not so sure...

 

There were definately some people I knew in primary school who could have benefited from some drugs - it would have saved a *lot* of fistfights...

OTOH, he was pretty extreme. I don't agree with giving drugs to simply disruptive kids - that's pretty bleh ... certainly not just to shut them up.

 

I work in a psychiatric ward for people with serious mental conditions and as far as I can tell pretty much all serious mental disabilities wont show or even evolve until late teens or early adulthood.

The person might have had problems before or been a bit different but no serious diagnosis can be done until the late teens. "Letter" disorders like ADHD tend to be a part of many but not all people who evolve a "real" condition like schizophrenia or borderline. Medically treating children with strong psychopharmaka seems alien to me. Using amphetamine based drugs on children with ADHD seems to give good results but it is basically treating the symptons and helping the child get through his or her schooling.