Drugging the kids

Saturday, June 7, 2008

Psychotropic drugs help, parents say




With kids, it’s really different. There’s not a lot of testing that’s been done on children.

Sarah J. Michael,


For Worcester parent Sarah J. Michael and her daughter, Ashleigh, the past 18 years have been one long struggle with doctors, therapies and medications as the family searched for a way to master Ashleigh’s mental illness.

She has been diagnosed with post-traumatic stress disorder, bipolar disorder and attention-deficit (hyperactivity) disorder. Now 18, she is a patient at Worcester State Hospital, her mother said, where she is finally receiving the therapy and a “pretty powerful combination” of psychotropic medications that are noticeably helping Ashleigh.

“It’s a constant struggle to try and get it right,” Ms. Michael pointed out.

The use of psychotropic medications by children and teenagers has been a controversial issue for parents and professionals. The Parent/Professional Advocacy League of Massachusetts earlier this week released the results of a survey on family reaction and satisfaction with psychotropic medications given to children with mental health disorders. PAL is a network of about 4,000 families in Massachusetts who have children with some mental, behavioral or emotional disability. The U.S. Surgeon General’s office has estimated that one of every five Americans 18 or younger has a diagnosable mental disorder, and the U.S. Department of Health and Human Services concludes that one in 10 has a serious, impairing mental illness such as bipolar disorder, severe depression, or anxiety disorder.

More than 250 parents and about 80 children were surveyed for this report, “Medications and Choices: The Perspective of Families and Youth.” PAL Executive Director Lisa E. Lambert said it is the first study of its kind because it focuses on the opinions of the families, rather than doctors and psychiatrists.

“No one was actually asking the people making the decisions,” she said.

The study consisted of a 52-question survey with a space for further comments if the parent or child desired. Ms. Lambert said the number of added comments was surprising, about 60 percent of those surveyed.

“We got this really large outpouring from families,” she said.

The study concluded that parents are highly satisfied with medications as treatment for their children, but that the process of arriving at that treatment is difficult.

According to the report, 50 percent of families tried another form of treatment before beginning medication and that less than 5 percent suggested the use of medication themselves. Usually the discussion was initiated by the child’s doctor or psychiatrist. Ms. Lambert said parents reported trying everything from yoga to specialized diets before beginning a trial period for medications. The struggle then becomes finding the right combination of medicines for the child.

Ms. Michael said Ashleigh’s medications have been effective, although “the cocktail changes often.”

“It has been a very long road,” she said.

People who suffer from bipolar disorder can never really be cured, Ms. Michael said, but can live well with a combination of medication and therapy. For Ashleigh, she said, the medication helps to control the more violent aspects of her mood swings, so that she can continue her education and therapy.

When her daughter’s doctors have suggested medications, Ms. Michael said, it was sometimes hard to get any history of their use in children.

“With kids, it’s really different,” she said. “There’s not a lot of testing that’s been done on children.”

Ms. Michael added that the balance between the different kinds of medications as well as therapy is essential for Ashleigh’s continued wellness.

Among the surveyed families, the most common medications being taken were mood stabilizers, ADHD medications and anti-psychotics. Ninety percent of the families said medications helped their children deal with their disabilities more effectively, and 74 percent said they are completely satisfied with the results.

In 2004, the federal Food and Drug Administration issued a warning about an increased risk of suicide in children taking certain pyschotropic drugs. The FDA also conducted a review of antidepressant trials in children between 1988 and 2006, concluding that the benefits of such medications outweigh the risks for most children, but that in certain individuals, the risk for suicidal thoughts and behaviors was almost doubled by the treatment.

The state PAL study notes an increase in the prescription of psychotropic medications for those 18 or younger. It notes that 60 percent of the medications administered by public school nurses are for mental or behavioral issues.

Parents within the PAL network expressed a very different experience than previous research and media had shown, Ms. Lambert said. Their struggle with balancing positive experience and the negative view of medication often held by society is part of what prompted the study.

Changing the stigma toward families who choose psychotropic medications for their children is one goal that PAL hopes to see come out of this, Ms. Lambert said.

“One thing we’re hoping for, obviously, is to challenge some of the commonly held beliefs,” she said.

Ms. Michael said she also struggled with the stigma of mental disability at times. Other parents would say that Ashleigh looked fine, but would keep their children from playing with her.

“It’s not anything that she could have done differently,” Ms. Michael said.

The organization also hopes that the study will enlighten medical professionals to the important role they play in the education of parents about medicating their children.

According to the report, almost half of the parents considered their child’s psychiatrist the most reliable source for information.


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