Courtney Sherman, BA – Brain Blogger http://brainblogger.com Health and Science Blog Covering Brain Topics Wed, 30 May 2018 15:00:03 +0000 en-US hourly 1 https://wordpress.org/?v=4.9.6 Psychotropics and Youth, Part 3 – Equip Teachers with Prescription Pads? http://brainblogger.com/2010/03/09/psychotropics-and-youth-part-3-equip-teachers-with-prescription-pads/ http://brainblogger.com/2010/03/09/psychotropics-and-youth-part-3-equip-teachers-with-prescription-pads/#comments Tue, 09 Mar 2010 12:00:44 +0000 http://brainblogger.com/?p=3994 Contentious debate is brewing over the large role educators play role in recommending what students receive psychotropics, even though they have limited knowledge of treatment. Consider the standards by which one teacher described the benefits of psychotropics to researchers in a recent pilot investigation: the children are “better able to attend to their work… they can stay on task, they can stay in their seat, and are generally more compliant.” Not surprisingly, society and now the government are taking a hard look at the golden rules for educator intervention in student psychopharmacology.

The Pilot Investigation of Teachers’ Perceptions of Psychotropic Drug Use in Schools by Lien, Carlson, Hunter-Oehmke and Knapp presents a startling finding — “more than half the parents seeking medication treatment for their child’s externalizing behavior in one pediatric setting were doing so as the result of recommendations from school personnel.” Yet, the teachers in their study responded that they had “none or limited” (88.9% and 100% respectively) training on children’s mental health problems or the medications prescribed to treat them.

The teachers involved in the study’s answer to this dilemma? They want more training in the area of child psychopharmacology and more collaboration with parents and physicians who prescribe the medication, which at present is a near non-existent relationship. In short, they want to become an integral part of the child’s treatment plan.

Society at large however, begs to differ. Legislation is markedly on the rise to limit the role of educators of all stripes in student psychopharmacological treatment. In fact, while the American Psychiatric Association (APA) and others advocate in favor of certain psychotropics for youth, an increasing number of lawsuits are challenging the use of this medication altogether. The legal actions involve questions such as the validity of psychiatric tests, the need for side effect warnings, and studies indicating psychotropics like Ritalin can lead to substance abuse.

In the United Kingdom, the National Institute of Clinical Excellence (NICE), an organization that issues health guidelines, has questioned to the exorbitant uptake in young people on psychotropics, as well as studies indicating that some antidepressants may increase suicidal tendencies. NICE’s most current report flatly asserts that only in cases of “severe depression” should psychotropics be administered in combination with “talking therapies.”

While the two schools of thought slug it out, The No Child Left Behind Act of 2001 prohibits federal intervention in education issues, placing the ball in state and local courts. As it currently stands, legislation against school and child psychotropic liaisons is the trend du-jour. What do you think?

References

Wegner, L. (2005). Pediatricians and Antidepressant Medications: Black Box or Black Hole? PEDIATRICS, 116 (1), 233-235 DOI: 10.1542/peds.2005-0928

Lien, M., Carlson, J., Hunter-Oehmke, S., & Knapp, K. (2007). A Pilot Investigation of Teachers’ Perceptions of Psychotropic Drug Use in Schools Journal of Attention Disorders, 11 (2), 172-177 DOI: 10.1177/1087054707300992

Lakhan, S., & Hagger-Johnson, G. (2007). The impact of prescribed psychotropics on youth Clinical Practice and Epidemiology in Mental Health, 3 (1) DOI: 10.1186/1745-0179-3-21

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Psychotropics and Youth, Part 2 – The Solutions http://brainblogger.com/2010/02/28/psychotropics-and-youth-part-2-the-solutions/ http://brainblogger.com/2010/02/28/psychotropics-and-youth-part-2-the-solutions/#comments Sun, 28 Feb 2010 12:00:52 +0000 http://brainblogger.com/?p=3905 “Prescribed psychotropic medications are now high on the research agenda,” assert Lakhan and Hagger-Johnson. Their study advocates new approaches to research to address the rising concern over dramatic increases in psychotropic prescriptions for both children and young.

Our first post delineated the five erroneous myths often adhered to when prescribing youth’s psychotropic medication. Here are the three areas of recommended research to address this “alarming” problem.

1) Clarify child/adult differences for psychotropics. The future promises to see questionnaires and interviews tailored specifically to children and adolescents. Prominent will be the initiation of normative data for youth mental disorders. Studies will need to focus on specific age groups, disorders and treatments.

2) Attend to the growth of “cosmetic” use of psychotropics in children and adolescents. Researchers’ alarm over the marked increase in psychotropic prescriptions for youth has spilled over into the public arena. Recent media attention, in conjunction with changes in clinical practice standards and drug product labeling, has juggernauted psychotropic investigation to the forefront of the research agenda.

3) Address concerns about the diagnostic validity of mental illness in the current DSM classification system. Due to lack of psychotropic research on youth, the current DSM system is flawed, Lakhan and Hagger-Johnson noted. Ethical challenges such as reluctance to enroll children in psychotropic clinical trials and the lack of “well-designed”, placebo-controlled trials have traditionally been barriers to effective research. Increasingly, the idea of hands-on research with children is more palatable.

Lakhan and Haggar-Johnson remind us that “for the first time, we can begin to record and measure, rather than assume, the impact of prescribed psychotropics on children and adolescents.” The final verdict — children and adolescents need accurate, age-appropriate data that does not exist today.

Reference

Lakhan, S., & Hagger-Johnson, G. (2007). The impact of prescribed psychotropics on youth Clinical Practice and Epidemiology in Mental Health, 3 (1) DOI: 10.1186/1745-0179-3-21

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Psychotropics and Youth, Part 1 – The Five Myths http://brainblogger.com/2010/02/13/psychotropics-and-youth-part-1-the-five-myths/ http://brainblogger.com/2010/02/13/psychotropics-and-youth-part-1-the-five-myths/#comments Sat, 13 Feb 2010 12:00:01 +0000 http://brainblogger.com/?p=3814 “The dramatic rise in prescriptions [of psychotropics for children and young adults] has alarmed several commentators,” according to Lakhan and Hagger-Johnson. In their article, they trace this problem to five erroneous myths that influence prescribing:

1) Children are little adults. During adolescence, the brain changes rapidly. As a result, therapeutic benefits, potential adverse occurrences, and drug interactions can vary with age. Adolescents, in particular, have unique characteristics meaning inconsistent results and effects. For example, SSRIs are being prescribed less for adolescents because studies have identified increased suicide risk among adolescents taking them.

2) Children have no reason to develop depression or anxiety. Researchers estimate “2-6% of children and adolescents in the community suffer from depression.” In addition, a report prepared by Hankin, Abramson, and Siler indicate between the ages of 15 to 18, depression rises from 8% to 18%. There are significant risk factors for youth depression, including genetic predisposition, stress, negative thought processes, and overall environmental factors such as bad parenting.

3) Psychiatric disorders are the same across adults and children. Depression is depression, but the symptoms are not the same for adults and children. For example, clinicians categorize irritability in children and adolescents as a core symptom of depression, but the same is not true for adults. What’s more, adult measures are more static, and treatment follows suit. However, disorders can change with age for younger populations making the child’s disorder a moving target for physicians.

4) Children can be prescribed lower does of the same drug. There is currently not enough evidence to substantiate this claim. Body weight is a factor, age is not.

5) Drugs are successful at treating psychiatric disorders. Pharmacological treatments are not the only or necessary the best option for all conditions. For example, cognitive behavioral therapy (CBT) and parental training can help treat and prevent conduct disorders.

In today’s highly evolved world of psychiatry, research has proven mental illnesses can begin in childhood or early adulthood. There is no question treatment is necessary to combat this grave problem. However, debate is continuing to grow about the over-reliance of psychotropics. In my next post, I will identify three areas of research that can provide answers to this alarming issue.

References

Lakhan, S., & Hagger-Johnson, G. (2007). The impact of prescribed psychotropics on youth Clinical Practice and Epidemiology in Mental Health, 3 (1) DOI: 10.1186/1745-0179-3-21

Hankin, B., Abramson, L., & Siler, M. (2001). A prospective test of the hopelessness theory of depression in adolescence Cognitive Therapy and Research, 25 (5), 607-632 DOI: 10.1023/A:1005561616506

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