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Doctors Overmedicating Kids


You've probably seen this your morning news stories, but doctors are being blamed (imagine that) for overmedicating kids (again). In fact, according to a study reported by the Associated Press, American children are taking what are called "anti-psychotic" drugs at a rate six times higher than children in the UK.

Does it mean U.S. kids are being over-treated? Or that U.K. children are being under-treated? Experts say that's almost beside the point, because use is rising on both sides of the Atlantic. And with scant long-term safety data, it's likely the drugs are being over-prescribed for both U.S. and U.K. children, research suggests.
What are "anti-psychotic" drugs? Well, according to the article, the most commonly prescribed drugs in the UK in this study have the names of risperdal and thioridazine. Now, I have to tell you that these are medications that I hardly use in adults. And, I have never used these drugs in children.
The new U.K. study, involving 1992-2005 health records of more than 16,000 children, is the first large examination of these drugs in U.K. children. It found the increase was mostly in medicines that haven't been officially approved for kids. They were most commonly prescribed for behavior and conduct disorders, which include attention deficit disorder.
Ah, HA! Here we go. The issue of attention deficit disorder is so divisive among the parents, teachers, and docs that I talk to - that this article will continue to fuel the fire. There are some who debate whether this diagnosis even exists. There are others who believe that docs do not medicate these kids enough. So, why do US docs medicate kids more?
A recent report in The Lancet suggested that the U.K.'s universal health care system limits prescribing practices there. The report also said direct-to-consumer ads are more common in the United States. These ads raise consumer awareness and demand for medication.

While drug company ties with doctors are common in both the U.S. and U.K., Vanderbilt University researcher Wayne Ray said U.K. physicians generally are more conservative about prescribing psychiatric drugs. Ray co-authored the U.S. study, published in 2004.

So, again, it's the doctors fault that American kids are overmedicated for attention deficit disorder. What is new about that? It'll be interesting to see how the parents, teachers, and medical blogs will react to this report today. We'll see.

Finally, if you haven't seen this already, the American Heart Association made a statement last month that kids who will be receiving attention deficit disorder drugs - these kids should receive a heart test (ECG/EKG) before start of these medicines. The American Academy of Pediatrics has not taken a position on this recommendation as of yet. But, this recommendation could have a huge impact. Here is what's on the AAP website:

The American Heart Association is now recommending children with attention deficit hyperactivity disorder (ADHD) should have heart tests - including an electrocardiogram (ECG) - before starting treatment with stimulant drugs. The AAP is evaluating the science behind these recommendations and will offer its guidance in the near future. Meanwhile, parents with questions or concerns about the AHA statement should consult their child's pediatrician.
By the way, just to clarify, family docs also take care of kids. Why couldn't they say "consult their child's physician." Sheesh.