First Lady Hillary Rodham Clinton on Monday announced a federal program to study the use of psychiatric medications, especially among children aged 2 to 4, and to require additional warning labels on the drug packages. Most of these medications are not approved for children, says Daniel J. Safer, an associate professor of psychiatry at Johns Hopkins, Division of Child Psychiatry, who co-authored the JAMA study that drew the White House s attention. As is the case with just about any drug, he says, clinical drug trials typically do not involve children. These drugs should not be used as quick pharmacological fixes for emotional or behavioral problems, but rather as a part of a broader treatment that includes behavioral therapy. Medication alone is rarely an appropriate or sufficient treatment, Fassler says.
Experts say the changing face of the health care system has a role as well.
More pediatricians and family practitioners are prescribing psychiatric drugs, not just psychiatrists, and some managed care companies will cover a drug but not a broader range of treatments, which may be more expensive but are more effective. Some also argue that there is a societal component. Experts say we expect children to be developmentally more mature younger and younger, and some of them aren t able to cope. Increasingly, toddlers, who typically have high activity levels, go off to daycare or preschool while their parents go to work. Leading experts say the more active, more inattentive children stand out in these more structured environments, and they worry that as a result attention-deficit disorders are diagnosed unnecessarily too often.