Medicating America’s Youth

by Daniel Smiechowski

Today, more than 1 million children take anti-psychotics every year, with under 5 years old being the fastest growing population.  75% of these drugs are used ‘off label’ – not even approved by the FDA for the condition the doctor is treating.  The other class of drugs that is showing rapid growth, is stimulants, used primarily for ADD and ADHD. Both classes of drugs can have severe side effects on development. I believe in people’s ability to make their own informed choices and that not all drugs misused; however, they do all affect the developing brain and this is something not one of us can afford to ignore.

Antipsychotics are not just for psychosis and are used for a variety of conditions, such as Oppositional Defiant Disorder and Intermittent Explosive Disorder.  These disorders often or always act with disproportionate, overly aggressive behavior with extreme outbursts, which cannot be treated with therapeutic services alone. They are powerful drugs with powerful effects and should be used with caution.  Some known side effects include:  Developmental delays, hormone abnormalities (including male breast growth), weight gain, sedation, memory deficits and an irreversible condition called Tardive Dyskinesia.  This condition causes permanent involuntary movements, jerks and ticks.  Also, brain scans have shown long lasting changes in neural circuitry.

Another diagnosis, which is commonly co-morbid with the aforementioned disorders, is ADD and ADHD.  Commonly, stimulants are the drug of choice for these diagnoses.  These diagnoses reflect an inability to process, focus and pay appropriate attention to tasks without distractions and/or hyperactivity.   Stimulants have side effects such as:  Growth suppression, over-stimulation, agitation, weight/appetite loss, violence, psychosis, mania and suicidality.

The pharmaceutical industry is a 330 billion dollar industry with 10 million of America’s kids taking prescription medication.  So if pills are not always the answer or only partially, what do we do? Sometimes symptoms are misleading and taken out of context. Some researchers have found that kids can improve or even ‘cured’ with a proper diet, screening for exposure to toxins (metal, lead, mercury) and an increase in sunlight exposure and exercise.  One study found that Cognitive-Behavioral treatments to be as effective as medications for depression.  Please note though, that severe cases can rarely be treated without any medication.  The behavior is simply too extreme, unmanageable and destructive to themselves and/or others to do without medication.

Therefore, if we do not use medications at all, in some cases, suicidal/homicidal reactions may occur.  I recollect children, mostly ages 2 through 10, whose medical information I was reviewing to approve services, presented with horrific behaviors.  Kids who have been kicked out of multiple pre-schools, forced to wear helmets to not injure themselves when they bang their heads, punching and kicking other students and teachers.  These kids, however, were not just receiving anti-psychotics, but 1:1 therapy and aides at school and home for as much as 20+ hours a week.  The medications stabilized them enough to be less destructive.  Also, studies show that ignoring long term depression and anxiety in the pre- and post-adolescent phase may increase the risk for suicide or acting out homicidal fantasies.  And children with ADD/ADHD treated without medications, can be so impulsive, they are more prone to multiple accidents, ER visits, etc.  But what about those ‘drug intoxicated brains’?

This is a balancing act that is quite precarious but can be achieved with some general techniques.  First, medications alone will not fix the problem, they are only to be used to stabilize and soothe the child’s brain enough to do the therapeutic work necessary for recovery.  They should be used with extreme caution, in the smallest dose possible and the least amount for as little time possible.  Parents, you must do your homework.  Study and research any medications and always use them in combination with some form of therapy and community support.  Find a psychiatrist specializing in treating children and insist on more services and direction than simply popping a pill. If your doctor cannot help you, find another.  Ask the doctor about the side effects, if it has been FDA approved for kids with this disorder, and if there are any other additional alternatives you can try first, prior to medication.  Most would prefer not putting their growing child something that causes unknown changes in their brain.    Some do not have a choice but know that many do. Just know that you know your child best and stay educated and hopeful.

Shauna Fisher holds a Master’s degree in Social Work from Rutgers University. Working in the field for over 10 years with children, families and adults, she is an accomplished social worker with experience ranging from direct clinical care to case management services and much more. Shauna may be reached at:

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