More and more young kids are being prescribed anti-psychotics off-label
April 12, 2017 5:54 AM Subscribe
In 2014, nearly 20,000 prescriptions for atypical anti-psychotic drugs like Risperdal, Abilify, Zyprexa, and Seroquel were written for children 2 years old and younger, up from 13,000 the previous year.
That example is just horrifying. So the doctor over-prescribing the medication to your child is being paid as a speaker for the manufacturer of that medication, and gets paid kickbacks for prescribing that medication.
And at the end of it all J&J get fined 2.2 billion, while they've netted 30 billion in /profits/.
But on the flip-side, at least the kid now sits still, right? *screams*
Here's the 65 part questionnaire mentioned.
posted by Static Vagabond at 7:33 AM on April 12, 2017 [6 favorites]
And at the end of it all J&J get fined 2.2 billion, while they've netted 30 billion in /profits/.
But on the flip-side, at least the kid now sits still, right? *screams*
Here's the 65 part questionnaire mentioned.
posted by Static Vagabond at 7:33 AM on April 12, 2017 [6 favorites]
Oh fer crying out loud. That questionnaire is pretty well a list of "things kids under 10 do". How the heck would the results of that survey be indicative of anything?
posted by fimbulvetr at 7:42 AM on April 12, 2017 [5 favorites]
posted by fimbulvetr at 7:42 AM on April 12, 2017 [5 favorites]
That questionaire has some very auspicious questions... perhaps some are meant to not count toward any particular score? For instance, " is very intuitive and/or very creative"... Oh Noes - better get this child on some off-label anti-psychotic drugs!
posted by beatThedealer at 7:47 AM on April 12, 2017
posted by beatThedealer at 7:47 AM on April 12, 2017
When I started the article, I asked myself, horrified about the Risperdal prescription for a kid that young, "Don't they worry about the long-term results of such a powerful drug on a quickly developing young brain?"
I was surprised and even more horrified to find out that the article had an answer to my question. (I should have added the word "body" to brain. After all, we are not brains that utilize a skeletal/muscular system to pull around our true brain-based selves; we are bodybrains.)
posted by kozad at 7:48 AM on April 12, 2017 [3 favorites]
I was surprised and even more horrified to find out that the article had an answer to my question. (I should have added the word "body" to brain. After all, we are not brains that utilize a skeletal/muscular system to pull around our true brain-based selves; we are bodybrains.)
posted by kozad at 7:48 AM on April 12, 2017 [3 favorites]
And people wonder why I don't like to go to the doctor even when I need to. I feel complicit in things like this. Not that we all aren't, because we are, but even more so than average.
posted by RolandOfEld at 7:49 AM on April 12, 2017 [4 favorites]
posted by RolandOfEld at 7:49 AM on April 12, 2017 [4 favorites]
I haven't read the article yet, and probably won't have a chance for a while (stupid day jobs). But for a very long time magazine articles about "oh my goodness overmedicating AD/HD what are they giving our poor children" with shocking covers depicting cramming pills in cute babies did untold amounts of damage to the cause.
It contributed to the mental illness stigma, encouraged widespread diagnosis skepticism and second-guessing, kept kids away from doctors and undermedicated or unmedicated altogether.
Who knows, maybe this article is valid. But I do not trust it and will be reading it with extreme criticality. Because I will probably never be "over" what they did to people like me before with this stuff.
posted by traveler_ at 7:59 AM on April 12, 2017 [11 favorites]
It contributed to the mental illness stigma, encouraged widespread diagnosis skepticism and second-guessing, kept kids away from doctors and undermedicated or unmedicated altogether.
Who knows, maybe this article is valid. But I do not trust it and will be reading it with extreme criticality. Because I will probably never be "over" what they did to people like me before with this stuff.
posted by traveler_ at 7:59 AM on April 12, 2017 [11 favorites]
traveler, I agree, however, and I say this as someone who was put on Ritalin at the age of 10 and wishes it had been earlier (I was diagnosed at 6 and my parents did their best to keep me off meds for a few years), the powerful side effects of the atypical antipsychotics put them at a whole new level. Also, increasing his dosage when he was already having severe side effects instead of seeing if another medication would work without them seems negligent. He should have been treated from the ADHD and possible PBD, however the method by which they did it seems wrong.
On the other hand, I tried to take that questionnaire as if I was looking at my 7 year old self. And it nailed the ADHD perfectly. This is not a list of what 5-7 year olds get up to. If it happens occasionally, that's normal. But when a child cannot sit still at any time, gets emotional at the drop of a hat and is constantly "able to focus intently on subjects of interest and yet at times is easily distractible" (question 15), those are signs of possible ADHD. There is a difference, one that it frustrates me when I see people dismissing.
When I was diagnosed at age 6, my parents were told to not think about college but instead just focus on keeping me out of jail. This was said by the diagnosing psychiatrist. I am glad this view is no longer expressed. I do worry about using atypical antipsychotics on kids with ADHD and Bipolar Disorder, especially as this is off label and there are plenty of on-label drugs that are already around for the treatment of these conditions.
posted by Hactar at 8:27 AM on April 12, 2017 [9 favorites]
On the other hand, I tried to take that questionnaire as if I was looking at my 7 year old self. And it nailed the ADHD perfectly. This is not a list of what 5-7 year olds get up to. If it happens occasionally, that's normal. But when a child cannot sit still at any time, gets emotional at the drop of a hat and is constantly "able to focus intently on subjects of interest and yet at times is easily distractible" (question 15), those are signs of possible ADHD. There is a difference, one that it frustrates me when I see people dismissing.
When I was diagnosed at age 6, my parents were told to not think about college but instead just focus on keeping me out of jail. This was said by the diagnosing psychiatrist. I am glad this view is no longer expressed. I do worry about using atypical antipsychotics on kids with ADHD and Bipolar Disorder, especially as this is off label and there are plenty of on-label drugs that are already around for the treatment of these conditions.
posted by Hactar at 8:27 AM on April 12, 2017 [9 favorites]
I don't want to get into it too much- in no small part because I can't really remember it well anyway- but I was prescribed Risperdal off label for severe anxiety and social phobia in my early teens and my experience was, while not as extreme as the kid in this article, horrible. It was sedating, I had mild TD in the form of shaky hands and fingers for a few years afterward, gained a ton of weight and suffered from metabolic syndrome's aftereffects for years until I made a concerted effort to take charge of my health. The issue here isn't the use of the medication per se, but the overuse of an extremely potent medication with severe side effects for illnesses for which it has neither been approved nor extensively studied. That's incredibly dangerous and irresponsible.
posted by Merzbau at 8:29 AM on April 12, 2017 [5 favorites]
posted by Merzbau at 8:29 AM on April 12, 2017 [5 favorites]
I was going to post that comment and leave it, but witchen's comment exemplifies my annoyance with people dismissing the symptoms of early psychiatric issues with "just being kids." Back in the day, we did not treat kids who couldn't sit still in class or had real trouble paying attention, etc. Instead we failed them in school (kicking them out of classrooms if necessary) and then, when they were too hyperactive at home, spanked them repeatedly. The issue here isn't the diagnosis. The issue here is the heavy use of medications that should not be used as the first stab at assisting children who have ADHD and Bipolar.
posted by Hactar at 8:42 AM on April 12, 2017 [12 favorites]
posted by Hactar at 8:42 AM on April 12, 2017 [12 favorites]
Somewhere in between "kids being kids" and "medicate all the things" is a good place to start. I won't get into the details of our journey, but what helped my kids the most (as opposed to all the other things that didn't) were the choices we made when we based them on certain specific criteria:
1. All kids have to grow into being functional people within our fairly arbitrary societal structure and expectations;
2. All kids need as much support and understanding as you can give them, to help them navigate complexities that they might not yet be equipped to handle;
3. All kids need to have opportunities to fail, be misunderstood, be unhappy, be angry, be unpleasant, and be wrong -- and then have the opportunity to learn how to deal with those feelings and circumstances.
Does that mean no children need meds? No, it's just the place to start from. Don't ignore your kids, and don't expect your kids to be perfect little simulacrums of kids you see on television, or of the neighbor's kids whom you only see in their little moments of public good behavior. Recognize that parenting is hard, often, and that doesn't make you or your children bad or broken.
Seen through that lens, it becomes a little easier to do things like forgive mistakes and annoyances, talk with teachers to advocate for the support your kids need in school, and take on other day-to-day activities that help your kids -- who may or may not have severe issues -- deal with everything life throws at them.
It also helps you differentiate between challenging but normal behavior, behavior that needs your intervention, and behavior that needs professional intervention. It might also help you isolate issues that originate in your child from issues that originate from their environment, their age, their situation, their siblings, or you.
posted by davejay at 9:23 AM on April 12, 2017 [3 favorites]
1. All kids have to grow into being functional people within our fairly arbitrary societal structure and expectations;
2. All kids need as much support and understanding as you can give them, to help them navigate complexities that they might not yet be equipped to handle;
3. All kids need to have opportunities to fail, be misunderstood, be unhappy, be angry, be unpleasant, and be wrong -- and then have the opportunity to learn how to deal with those feelings and circumstances.
Does that mean no children need meds? No, it's just the place to start from. Don't ignore your kids, and don't expect your kids to be perfect little simulacrums of kids you see on television, or of the neighbor's kids whom you only see in their little moments of public good behavior. Recognize that parenting is hard, often, and that doesn't make you or your children bad or broken.
Seen through that lens, it becomes a little easier to do things like forgive mistakes and annoyances, talk with teachers to advocate for the support your kids need in school, and take on other day-to-day activities that help your kids -- who may or may not have severe issues -- deal with everything life throws at them.
It also helps you differentiate between challenging but normal behavior, behavior that needs your intervention, and behavior that needs professional intervention. It might also help you isolate issues that originate in your child from issues that originate from their environment, their age, their situation, their siblings, or you.
posted by davejay at 9:23 AM on April 12, 2017 [3 favorites]
It is too early in the morning for me to go read TFA, because incandescent rage is not how I like to start my day. But I read it anyway. So. ANGRY.
Because I have taken all 4 of the drugs mentioned at the top. I knew what I was taking. They are not drugs that should be taken lightly, and unless you are actually psychotic, never as a first-line treatment. They all have awful side-effects, often with lasting damage. Bad enough for adults, but for children... I do not have the words. These drugs are so much worse than stimulants. SO MUCH WORSE.
It is a nasty cycle of greedy pharma companies, irresponsible doctors, and patients who blindly shovel down, or worse give their children, whatever they're given without even a cursory Google or even a look at the page of info that the pharmacy gives you. Ultimately, you are responsible for what goes into your body. Is that not worth a quick look at the Wikipedia page, ffs? Or back in 2005, if your pharmacist couldn't help you by giving you the package insert or just explaining it to you, a quick trip to the library to look at the PDR?
I am going to go mutter to myself about people for a while now. Or maybe watch some kitten videos.
posted by monopas at 11:21 AM on April 12, 2017 [4 favorites]
Because I have taken all 4 of the drugs mentioned at the top. I knew what I was taking. They are not drugs that should be taken lightly, and unless you are actually psychotic, never as a first-line treatment. They all have awful side-effects, often with lasting damage. Bad enough for adults, but for children... I do not have the words. These drugs are so much worse than stimulants. SO MUCH WORSE.
It is a nasty cycle of greedy pharma companies, irresponsible doctors, and patients who blindly shovel down, or worse give their children, whatever they're given without even a cursory Google or even a look at the page of info that the pharmacy gives you. Ultimately, you are responsible for what goes into your body. Is that not worth a quick look at the Wikipedia page, ffs? Or back in 2005, if your pharmacist couldn't help you by giving you the package insert or just explaining it to you, a quick trip to the library to look at the PDR?
I am going to go mutter to myself about people for a while now. Or maybe watch some kitten videos.
posted by monopas at 11:21 AM on April 12, 2017 [4 favorites]
When I was diagnosed at age 6, my parents were told to not think about college but instead just focus on keeping me out of jail.
This would have been brilliant advice for the child psychiatrist to have given my mother when I was 6 and on Ritalin for ADD.
posted by strelitzia at 12:03 PM on April 12, 2017
This would have been brilliant advice for the child psychiatrist to have given my mother when I was 6 and on Ritalin for ADD.
posted by strelitzia at 12:03 PM on April 12, 2017
I was drugged with Risperdal, Zyprexa, and Abilify as an adolescent. I've looked at the evidence for these drugs' use in children, and the more I've learned, the more I'm convinced that it's not medicine; it's child abuse on a colossal scale.
This is absolutely criminal, and it's not going to stop until we start sending the people responsible — physicians, drug company executives, marketers — to jail. Bankrupt the companies and treat the drug pushers as mercilessly as the neighborhood crack dealer. I mean, at least the guys selling illegal drugs usually sell to consenting adults who have no illusions about the medicinal qualities of their purchase. These doctors and drug companies however, lie and destroy powerless children's lives with impunity.
posted by Wemmick at 2:33 PM on April 12, 2017 [3 favorites]
This is absolutely criminal, and it's not going to stop until we start sending the people responsible — physicians, drug company executives, marketers — to jail. Bankrupt the companies and treat the drug pushers as mercilessly as the neighborhood crack dealer. I mean, at least the guys selling illegal drugs usually sell to consenting adults who have no illusions about the medicinal qualities of their purchase. These doctors and drug companies however, lie and destroy powerless children's lives with impunity.
posted by Wemmick at 2:33 PM on April 12, 2017 [3 favorites]
I wonder how much of parents turning to and accepting medication is related to the limitations of resources for providing the care and structure that a slightly more hyper/needy child benefits from. Parents working longer hours with longer commutes with little discretionary income, higher student to teacher/adult ratios in schools, shorter (or no) recess, fewer (or now) enrichment classes that might channel a kids' energy or diffuse it (gym, band, music, art, drama), fewer funds for teachers to set up the physical spaces that might help, etc etc.
Then on top of that, the hyper competitive academic/career world that (I guess) many of the patients in this demographic inhabit. Like the thread we had about high school students committing suicide... if the cultural understanding is that in order to succeed (where succeed just means bread and some roses too), a person can't just be ok but has to be great, to be a star, at least at something. It doesn't leave much room for error.
posted by Salamandrous at 2:59 PM on April 12, 2017 [10 favorites]
Then on top of that, the hyper competitive academic/career world that (I guess) many of the patients in this demographic inhabit. Like the thread we had about high school students committing suicide... if the cultural understanding is that in order to succeed (where succeed just means bread and some roses too), a person can't just be ok but has to be great, to be a star, at least at something. It doesn't leave much room for error.
posted by Salamandrous at 2:59 PM on April 12, 2017 [10 favorites]
This case clearly needed intervention, and wasn't in the realm of normal toddler behavior... And was also causing safety issues to himself and other children.
BUT
I'm against these medications in kids in pretty much all cases including this one, and I hate doctors whose answers to problems are just more psychiatric medication. It's an doctor who isn't looking at the holistic well being of his/her patient. These side effects are obvious.
Slight Derail: Children's and I have some ethical disagreements (for example, they call dcfs on denial of coceclear implant in Deaf parents with Deaf children as medical neglect (*this was policy in 2010, not up to date). Overall the children's hospital and the outcomes in the early psych unit are really great and the work I've seen has been very detailed. The ten day overservational stay is amazing. Seriously. You will not find a better place in ILfor young children to be observed for behavioral interventions.
posted by AlexiaSky at 3:20 PM on April 12, 2017
BUT
I'm against these medications in kids in pretty much all cases including this one, and I hate doctors whose answers to problems are just more psychiatric medication. It's an doctor who isn't looking at the holistic well being of his/her patient. These side effects are obvious.
Slight Derail: Children's and I have some ethical disagreements (for example, they call dcfs on denial of coceclear implant in Deaf parents with Deaf children as medical neglect (*this was policy in 2010, not up to date). Overall the children's hospital and the outcomes in the early psych unit are really great and the work I've seen has been very detailed. The ten day overservational stay is amazing. Seriously. You will not find a better place in ILfor young children to be observed for behavioral interventions.
posted by AlexiaSky at 3:20 PM on April 12, 2017
On the other hand, I tried to take that questionnaire as if I was looking at my 7 year old self. And it nailed the ADHD perfectly.
Except that questionnaire is for identifying children with "early onset bipolar disorder", a relatively recent diagnosis that has fueled the prescription of heavy anti-psychotics like Risperdal.
posted by chainsofreedom at 5:54 PM on April 12, 2017 [2 favorites]
Except that questionnaire is for identifying children with "early onset bipolar disorder", a relatively recent diagnosis that has fueled the prescription of heavy anti-psychotics like Risperdal.
posted by chainsofreedom at 5:54 PM on April 12, 2017 [2 favorites]
To be clear, any psychiatric diagnosis outside of developmental and adhd prior to ten years old is rare and very suspect. Even ADHD is discussed tons in academia. You will see some PTSD and attachment disorders but even then with caution.
In the 11 to 15 range you'll start to see some kids with more dx, but it's still suspect, and generally concidered highly problematic. There is tons of literature out there on this topic. After 15ish you do start to see disorders with psychotic featutes appear more( schizophrenia, mania with psychotic features).
Generally kids get dxs due to involvement in public systems such as Foster care, special education programs, juvinile detention.
posted by AlexiaSky at 6:36 PM on April 12, 2017 [2 favorites]
In the 11 to 15 range you'll start to see some kids with more dx, but it's still suspect, and generally concidered highly problematic. There is tons of literature out there on this topic. After 15ish you do start to see disorders with psychotic featutes appear more( schizophrenia, mania with psychotic features).
Generally kids get dxs due to involvement in public systems such as Foster care, special education programs, juvinile detention.
posted by AlexiaSky at 6:36 PM on April 12, 2017 [2 favorites]
So y'all know that Risperdal increases prolactin production in the brain and that most generally you should not give a prepubescent boy anything like that unless you want him to start lactating (possibly), right? It's called gynecomastia. I've researched and written about this at length recently while covering a lawsuit.
Here's some pretty scary info about how Janssen saw a stat sig number of male children presenting with gynecomastia in their internal drug safety study soooooo whoops, let's just replace all those male test subjects under age 10 with girls. Problem solved! Gynecomastia rates down to .8%!
How the fuck these guys aren't in jail boggles the mind.
Look I take back what I just typed, if you really need it, then take it. But know what you (or more likely, your child) may be getting yourself into. Janssen literally gave out samples to pediatricians' offices that included candy and drug-branded legos.
But hey, at least one kid who grew 46DD breasts at age 7 got paid $2 million for his lifelong suffering. And J&J plus its subsidiary Janssen got nailed for illegal pediatric marketing practices.
posted by Unicorn on the cob at 9:56 PM on April 12, 2017 [9 favorites]
Here's some pretty scary info about how Janssen saw a stat sig number of male children presenting with gynecomastia in their internal drug safety study soooooo whoops, let's just replace all those male test subjects under age 10 with girls. Problem solved! Gynecomastia rates down to .8%!
How the fuck these guys aren't in jail boggles the mind.
Look I take back what I just typed, if you really need it, then take it. But know what you (or more likely, your child) may be getting yourself into. Janssen literally gave out samples to pediatricians' offices that included candy and drug-branded legos.
But hey, at least one kid who grew 46DD breasts at age 7 got paid $2 million for his lifelong suffering. And J&J plus its subsidiary Janssen got nailed for illegal pediatric marketing practices.
posted by Unicorn on the cob at 9:56 PM on April 12, 2017 [9 favorites]
This part really bothers me (among many other things): "In April 2006, Frankie fell down the stairs, telling his parents that his 'legs wouldn’t work.' That was when Lori finally typed 'Risperdal side effects' into a Google search box." That was almost TWO YEARS after Frankie started taking Risperdal. I know she trusted the hospital/doctor, but...
posted by trillian at 5:17 AM on April 13, 2017 [2 favorites]
posted by trillian at 5:17 AM on April 13, 2017 [2 favorites]
Thanks for this post. It gives me some new avenues in handling a young adult in my care. He was on a variety of psychiatric medications at an early age. We are currently in litigation over his treatment at his high school (he's just finishing). His #1 issue being failure to self-advocate, he was suspended for self-advocating himself right out of school one day, after his teacher ridiculed him in front of the class (long story, he was doing something good the teacher didn't comprehend. Called "reverie", on his way to class. There were concerns he wasn't doing that at all). This came after they essentially kidnapped him from his classroom, transported him against his will to a Catholic Church, where he was expected to work for the church, for free, as part of his "program".
The school decided to simply refuse to deal with me, as I refused to cooperate in any way, until they explain to me why they think that is okay. I went so far as to demand they prove their staff have ever passed a basic Civics class. They don't seem to understand the meaning of "age of majority" in Pennsylvania, amongst other issues, much less keeping the State out of the church.
posted by Goofyy at 6:51 AM on April 14, 2017
The school decided to simply refuse to deal with me, as I refused to cooperate in any way, until they explain to me why they think that is okay. I went so far as to demand they prove their staff have ever passed a basic Civics class. They don't seem to understand the meaning of "age of majority" in Pennsylvania, amongst other issues, much less keeping the State out of the church.
posted by Goofyy at 6:51 AM on April 14, 2017
yes, we are lawyered up. Not sure if she's good or not. She is an education lawyer.
posted by Goofyy at 6:54 AM on April 14, 2017
posted by Goofyy at 6:54 AM on April 14, 2017
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posted by justsomebodythatyouusedtoknow at 7:28 AM on April 12, 2017 [4 favorites]