Backlash to Pills in Preschool ; the White House Weighs in on Pill Dependence with a Move to Curb Use of Ritalin and Other Psychiatric Drugs

Article excerpt

When a recent study reported a sharp increase in the number of preschool children taking psychiatric drugs, parents and medical experts took notice.

So did first lady Hillary Rodham Clinton.

In short order, the White House has announced an initiative aimed at getting the word out that powerful behavioral drugs such as Ritalin and Prozac carry risks and that not enough is known about their effects in young children.

"I think what we have here is a national outcry at a grass-roots level that is finally reaching the government," says Peter Breggin, a psychiatrist in Bethesda, Md., and a longtime crusader against what he calls the overmedicating of children.

The Clinton administration's effort, while limited to younger children, sharpens questions about how much children of all ages are being medicated for disruptive behaviors. Recently, a United Nations panel criticized doctors in the United States for overprescribing psychiatric drugs. The panel reports that 80 percent of the world's Ritalin is consumed in the US.

The government initiative, announced yesterday, includes:

*Preparation of a guide for parents on how to treat young children with emotional and behavioral disorders.

*New labeling by the Food and Drug Administration that will instruct physicians on proper dosages of psychiatric drugs for young children. The FDA will soon instruct drug companies on how to conduct research into uses of hyperactivity and attention-deficit medications.

*A nationwide study by the National Institute of Mental Health on the safety and effectiveness of Ritalin use among preschoolers diagnosed with attention deficit hyperactivity disorder (ADHD).

*A White House conference this fall on the treatment of mental disorders among very young children.

Advocates for the rights of people diagnosed with ADHD agree with the need for more research on the use of psychostimulant medication among the young.

"The substantial increase in prescriptions to children ages 2 to 4 demands that we pay immediate attention to this situation," says a statement from Matthew Cohen, president of Children & Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), a group based in Landover, Md.

"While psychostimulant medication has been found to be safe and effective in older populations, it's imperative that we have the same level of assurance about its safety in young children before this trend continues."

The study that triggered this flurry of attention to children and psychiatric drugs was published last month in the Journal of the American Medical Association. It found Ritalin use for preschoolers had either doubled or tripled between 1991 and 1995, depending on the group being examined. The research was done by the University of Maryland and looked at two Medicaid programs and one HMO.

The use of antidepressants was up by 30 percent in the HMO and about doubled in the other two groups. …