Saturday, September 27, 2008

Our Children and Psychotropic Drugs

A new study published in Child and Adolescent Psychiatry and Mental Health found that American children are three times more likely to be prescribed psychotropic medications for conditions such as ADHA and bipolar disease than European children are. The researchers suggest the difference is in regulatory practices and cultural beliefs.

The lead researcher, Julie Zito, from the pharmaceutical health services research department in the School of Pharmacy at the University of Maryland, suggests there is significantly greater use of atypical antipsychotics and SSRI-type antidepressants for child mental health treatment in U.S. than in Western Europe. She also suggests that most of the use is 'off-label' -- without adequate evidence of benefits and risks, and that closer monitoring should be considered when these medications are used.

Researchers found that the annual prevalence of psychotropic medications among children in the United States was significantly greater than in either the Netherlands or Germany. In the United States, 6.7 percent of children were taking these drugs, compared with 2.9 percent in the Netherlands and 2 percent in Germany. In addition, use of antidepressants and stimulants was three or more times higher in the United States than in the Netherlands or Germany, and use of antipsychotic drugs was 1.5 to 2.2 times greater in the United States than in either of the other countries.

The study suggests that direct-to-consumer drug advertising, which is common in the U.S., is likely to account for some of the differences. The increased use of medication in the U.S. also reflects the individualist and activist therapeutic mentality of U.S. medical culture," the researchers concluded.

It has been suggested many times by researchers that the U.S. has a sick-care system, rather than a health-care system, with a particular emphasis on use of drugs and procedures for diagnosed conditions. This study reaffirms that pattern, with more use of medication for various mental health conditions among children in the U.S than other countries. What this study cannot show is whether the use of medication is appropriate, given variations in culture, or whether other countries under-prescribe psychotropic drugs or whether the U.S. over-prescribes them.

I put my money on over-prescribing.