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A soaring number of children are being prescribed a powerful class of drugs called antipsychotics. Research from Vanderbilt University shows the number of kids taking antipsychotics has increased at least five-fold since a decade ago.

Lauren Weinrich, 14, is one of those kids.

Growing up, Lauren would have violent outbursts. “You were always concerned about that phone call,” says her mom, Robin. “She could grab a knife. She could use a simple thing [such] as a fork.”

Lauren would physically hurt her brother and sister. Afterwards, she was sorry.

“I’d be like, ‘Oh my gosh! Don’t tell anybody, please! I’m so sorry!’” says Lauren.

To stop the violence, Lauren’s doctor prescribed an antipsychotic. “All of a sudden you’ve elevated the type of medication she’s taking,” says Robin. “It’s not just a simple antidepressant or mood stabilizer, now it’s an antipsychotic.”

Ten years ago, antipsychotics were mostly used to treat schizophrenia.

Now, kids are taking them for the aggression that comes with autism, attention deficit, or, in Lauren’s case, bipolar disorder.

“When she gets frustrated or angry now it’s mostly yelling and screaming,” says Robin, “but there’s no physical reaction.”

Doctors say they’ve seen antipsychotics work in adults, and that’s one reason they’re being prescribed to kids.

But no long-term studies show the drugs to be safe or effective in kids.

And they can have dangerous side effects.

“There are some studies that have shown serious weight gain in children and adolescents that have been started on these medicines,” says Dr. Shannon Croft, a child psychiatrist at the Emory University School of Medicine, “and some have gone on to develop diabetes because of the weight gain.”

Other side effects include a trembling similar to Parkinson’s disease — and damage to a child’s ability to think.

“So if you are going to give your child a medicine that is going to slow their ability to learn and then send them to school, that’s a serious thing,” says Dr. Croft. “You really want your child treated with the least amount of this medicine that is required, for the shortest period.”

Lauren’s mom is worried about future side effects, but her daughter needs help today.

“If we did not make the right decisions for her medically,” says Robin, “she could be in a hospital, she could be in a psychiatric unit, she could be in jail for killing somebody.”

Doctors say it is not a good idea for kids to suddenly stop taking an antipsychotic. Part two of this series addresses how to determine if your child really needs one of these powerful drugs.

What We Need To Know

• Realize antipsychotic medicines are not FDA approved for use in children. Parents whose children are prescribed these drugs should proceed with extreme caution. Ask the doctor if there are alternatives. If you are not sure whether your child really needs one of these drugs, get a second opinion. (Shannon Croft, M.D., Child Psychiatrist, Emory University School of Medicine)
• Realize many doctors believe anti-psychotics are too powerful for children who do not have a psychotic illness like schizophrenia. Some doctors and patients have found these drugs do calm outbursts in children with conditions like ADHD, bipolar, or autism – but the use of anti-psychotics for such conditions is controversial. (Shannon Croft, M.D., Child Psychiatrist, Emory University School of Medicine)
• If your child does start taking an antipsychotic for a non-psychotic illness, watch them closely for side effects. Realize the risk of side effects will increase the longer your child takes the medicine. Make sure you know the time frame when your doctor plans to take your child off the drug. Put your child on the lowest dose possible, for the shortest time period. (Shannon Croft, M.D., Child Psychiatrist, Emory University School of Medicine)
• Join a support group – so you can see if the treatment your child is receiving is in line with what other kids are getting. However, realize that what works for one patient does not necessarily work for another. Just because another child has a good or bad experience with a particular drug, does not mean your child will react the same way. The National Alliance for the Mentally Ill, or NAMI, has good support groups. (Shannon Croft, M.D., Child Psychiatrist, Emory University School of Medicine)
• Children on anti-psychotics should also be in therapy. These drugs are not a cure. They treat symptoms and not underlying problems. If children learn to control their behavior through therapy, they can be taken off this medicine as soon as possible. (Shannon Croft, M.D., Child Psychiatrist, Emory University School of Medicine)

Resources

• Shannon Croft, M.D., Child Psychiatrist, Emory University School of Medicine
• Ambulatory Pediatrics: Trends in Prescribing of Antipsychotic Medications for U.S. Children
• William Cooper, M.D., Associate Professor of Pediatrics, Researcher, Vanderbilt University School of Medicine

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