Psychotropics and Youth, Part 1 – The Five Myths
by Courtney Sherman, BA | February 13, 2010“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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