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Psychotropic drugs for children

Hi Paola,

Please see responses below to your questions.

What do you think about prescription of psychotropic drugs to child?

Diagnosis of mental illness in children and subsequent use of psychotropic medication has significantly escalated in the previous decade, even with the young toddler population (Julie Zito found that the use of psychotropic medication tripled between 1991 and 1995 in the two – four year old population). In Canada, 14.3% of children have received a mental health diagnosis, with an undetermined amount receiving psychotropic medication. Having worked as a school occupational therapist for a decade, I have witnessed without a doubt that some children do have mental illness that requires use of psychotropic medication. I have also witnessed children with significant technology overuse problems receive diagnoses of Autism, Aspergers, ADHD, anxiety and depression. Children now use an average 8 hours per day of combined technology (TV, internet, video games, cell phones), and as a result are not meeting critical milestones for normal physical and psychological development. Children require 3-4 hours per day of unstructured physical play with their peers to achieve sensory, motor and speech milestones. Unstructured play promotes necessary sensations of movement, touch and human connection, to eventually achieve optimal growth and success at school. Family physicians and pediatricians prescribe 80% of psychotropic medication, and are responding to parent and teacher concerns regarding complex child behaviors by diagnosing and medicating many of these children who overuse technology with drugs that have never been tested on this young population. Referencing pharmaceutical research literature will uncover information indicating that drug trials are usually performed on an age population 13 years or older, as they have great difficulty finding parents of young children who would volunteer to participate in a trial of an untested drug. Another issue with drug trials is that there is no long term data on use of psychotropic medication with young children. Psychotropic medication is referred as “neurotoxic” in much of pharmaceutical research literature due to the permanency of changes to neurotransmitter structures. Without clinical trials and long term data, in my opinion use of psychotropic medication with children younger than 13 years of age should be under the supervision of a child psychiatrist, and not performed by a family physician or pediatrician.

Do we need to have a new labeling changes for stimulant drugs?

As stated above, use of psychotropic medication with children younger than 13 years of age should be under the supervision of a child psychiatrist, and not family physician or pediatrician, and should be used only in conjunction with ongoing psychotherapy by a trained professional. I also advocate in my Unplug – Don’t Drug policy initiative, family physicians and pediatricians take a family technology usage history and if usage is high, request the family undergo a three month technology unplug trial prior to costly and lengthy psychiatric diagnosis and use of psychotropic medication (see www.zonein.ca for Unplug – Don’t Drug document). This technology usage history and technology unplug trial would offer the family physician or pediatrician crucial information with which to make an accurate diagnosis, or determine if the child should be referred onto a child psychiatrist for further investigation.

How to alert parents of the side effects of psycotropic drugs for children?

Read the packaging…it’s pretty scary. I’ve attached an advertisement for Vyvanse, a drug used to treat ADHD from Home, a design magazine Nov/Dec 2007 issue where a host of side effects are listed, taking up literally 1/3 of the full page advertisement.

Do we need changes in prescription strategy for paediatric psycotropic medications?

I pretty much answered this above, but from a pediatric occupational therapy perspective, would like to add some additional comments. Technology is a wonderful and necessary part of living in a advanced society, and in and of itself is not a bad thing. Parents, children and child health advocates in government and communities need to come together to help promote Balanced Technology Management, where we teach children to balance technology use with the critical factors of movement, touch and human connection, in order for them to grow and succeed.

Zone’in Programs Inc. offers products, workshops and training to address the impact of technology overuse on child health and academic performance. See www.zonein.ca or ZPI attachment for further information on how you can work with your parents, teachers and community to create Balanced Technology Management.

Aside note of interest – Zone’in Programs Inc. is partnering with Microsoft Canada Corporate Citizenship to promote Balanced Technology Management initiatives in homes and schools.

Have a GREAT day!

Sincerely,

Cris Rowan, BScOT, BScBi, SIPT, Approved Provider AOTA
CEO Zone’in Programs Inc.
6840 Seaview Rd.
Sechelt, BC V0N3A4
604-885-0986 office, 604-885-0389 fax, 604-740-2264 cell
email crowan@zonein.ca
website www.zonein.ca