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Over-Medicating Kids Leads to More Health Problems — and More Meds

Dr. Joseph Mercola


Story at a glance:

  • Children with behavioral and mental health conditions often fall victim to polypharmacy, the use of multiple medications at one time.

  • In Renae Smith’s case, which was profiled by The New York Times, she was prescribed 10 psychotropic medications while she was still in high school.

  • One systematic review found that up to 87% of children and youth with autism are prescribed two or more medications simultaneously.

  • From 2006 to 2015, prescriptions for attention deficit hyperactivity disorder (ADHD) medications among patients aged 2 to 24 years increased from 4.8% to 8.4%, while the percentage of those who were prescribed a drug for ADHD as well as at least one other medication rose from 26% to 40.7%.

  • Overprescribing pills is ultimately setting up children for a downward spiral of increasing side effects and worsening health, without addressing their health conditions.

Children in the U.S. are being plied with powerful drugs to treat mental health concerns. The medications, however, don’t get to the root of the problem and often create new problems of their own — symptoms that are then treated with more medications. According to mail-order pharmacy Express Scripts, prescriptions for antidepressants for teenagers increased 38% from 2015 to 2019, while such prescriptions for adults rose 12% during that time. Note that this was prior to the pandemic, during which social isolation and other fears may have pushed some children with mental health issues “over the edge.” Significantly higher rates of suicide-related behaviors, including suicide ideation and suicide attempts, also corresponded to times of increased COVID-19-related concerns, the end result being that even more children have likely been prescribed psychotropic drugs compared to in 2019, before the pandemic. Children prescribed multiple — even 10 — drugs It’s hard to imagine a reason to prescribe nearly a dozen psychotropic medications to a healthy teenager. In Renae Smith’s case, the reasoning stems not from a clear-cut medical need but from disjointed care and overprescribing physicians who seemingly had no other options for care than doling out drugs. Smith, who was prescribed 10 psychotropic medications while she was still in high school, was profiled by The New York Times, which detailed her hefty regimen: “In 2021, the year she graduated, New Horizon [Counseling Center on Long Island] was prescribing her seven: Focalin; Trintellix; alprazolam, an anti-anxiety drug known to be addictive; Lamictal and Topamax, a combination of seizure and migraine medication that can be used to stabilize mood; “Rexulti, an “add-on” drug for adults who have major depressive disorder; and olanzapine, a drug used mainly for bipolar disorder and schizophrenia. (Ms. Smith said she was told that olanzapine would dull the side effects of the other medications and help her sleep.)” Smith, however, did not have bipolar disorder or schizophrenia, nor seizures or migraines. What she did have was feelings of depression and anxiety, along with some suicidal ideation, and a diagnosis of ADHD, which she received in fourth grade. Dr. David Lohr, a child psychiatrist at the University of Louisville, told The New York Times that ADHD is the “foundation of polypharmacy,” a term used to describe the use of multiple medications at one time. Multiple drugs for autism, depression and more Other mental health conditions, including autism, also have high rates of psychotropic polypharmacy. One systematic review found that up to 87% of children and youth with autism are prescribed two or more medications simultaneously. The researchers urged “further research to determine appropriate practices related to the monitoring of adverse side effects and the long-term impact of polypharmacy among autistic youth.” In another example of the rampant overprescribing, The New York Times reported: “Instances of polypharmacy do not always begin with a diagnosis of A.D.H.D. Last summer, Jean, 22, who is being identified by her middle name to protect her privacy, grew increasingly agitated and depressed before her senior year in college. “By April of this year, she was taking seven psychiatric medicines. They included lamotrigine, an anti-epileptic drug used for mood; hydroxyzine, gabapentin and propranolol for anxiety; escitalopram, an antidepressant; mirtazapine to treat major depressive disorder; and lithium carbonate, for general mood disorders, although it is also used to treat bipolar disorder, which Jean has not been diagnosed with.” Among the drugs prescribed to Smith at various points during her adolescence was Effexor, an antidepressant that’s not approved for use in children and increases the risk of suicidal thoughts and actions in children and young adults — especially in those who, like Smith, have had suicidal thoughts or actions in the past. She was also prescribed Abilify (aripiprazole), an antipsychotic drug often used to treat schizophrenia. Writing in Frontiers in Psychiatry, a team of researchers called for “safer” use of Abilify and Risperdal (risperidone) in children and adolescents after recording a range of adverse drug reactions related to their use. Ironically, they noted, “Psychiatric disorders were the main related adverse events for aripiprazole (20.2%) and among these, suicidal behavior was one of the most reported (14.9%).” Other reactions, including weight gain disorders, reproductive system disorders and metabolism disorders, were also reported, with 90% of them being serious. One drug prescription turns into two, and more Using drugs to cover up the symptoms of mental health conditions in children is a slippery slope that often leads to overprescribing. A study published in the journal Pediatrics in 2020 revealed that not only is the use of ADHD medication increasing but so is psychotherapeutic polypharmacy. From 2006 to 2015, prescriptions for ADHD medications among patients aged 2 to 24 years increased from 4.8% to 8.4%, while the percentage of those who were prescribed a drug for ADHD as well as at least one other medication rose from 26% to 40.7%. Most often, stimulants and α-2 agonists were prescribed together to treat ADHD, while the most common psychotropic agents prescribed in addition were selective serotonin reuptake inhibitors, or SSRIs and second-generation antipsychotics, or SGAs. “Surprisingly,” the researchers noted, “SGAs were co-prescribed with ADHD medications most frequently at visits in the youngest patients (2–5 years of age)” — possibly in an attempt to treat sleep difficulties. They added: “[T]he high use of multiclass drug combinations in children and adolescents is concerning, given their vulnerability to adverse effects and the unknown impact of long-term neurologically altering substances on the development of an immature brain and nervous system.” “Overprescribing pills is ultimately setting up children for a downward spiral of increasing side effects and worsening