For more than a decade, mental-health experts have been begging GPs to stop prescribing anti-psychotic drugs for children who don鈥檛 need them. Yet the message doesn鈥檛 seem to be getting through.
A team in Ontario reported last week that, Canada-wide, the number of children being given these powerful drugs rose 33 per cent between 2010 and 2013. The use of anti-depressants climbed 63 per cent.
Those results follow a study that found an 18-fold increase in the use of antipsychotics between 1996 and 2010. The ailments most often treated with these medications are mood disorders, such as attention-deficit hyperactivity disorder, and depression.
There are compelling reasons for concern. First, antipsychotics aren鈥檛 designed to treat behavioural problems. They鈥檙e meant to combat severe mental illnesses such as schizophrenia. Experts at B.C. Children鈥檚 Hospital say there is no evidence to support the use of these drugs for depression in children.
Second, most of these medications have serious adverse effects, including weight gain, Type 2 diabetes, suicidal thoughts and involuntary movements such as grimacing and tremors. Some of these afflictions are permanent.
Third, it鈥檚 not clear that medication is the proper response in many cases. A massive study in B.C. found that boys born in December were 30 per cent more likely to be diagnosed with ADHD than boys born in January. Girls were 70 per cent more likely. That doesn鈥檛 suggest a biological mechanism at work.
However the cut-off birth date for entry into the school system is December. In effect, kids being diagnosed most frequently were the youngest in their class. Is bullying perhaps the problem? If so, drugs are a poor answer.
Last, the share of health spending devoted to mental-health services across Canada has fallen from 11 per cent in 1979 to five per cent in 2014. Instead of providing therapy for kids in trouble 鈥� a resource-intensive process 鈥� perhaps medication is being used as a substitute.
The B.C. Health Ministry has recognized this issue, and $10 million has been set aside for a collaboration with physicians. The purpose is to create awareness of the problems associated with medicating children, and to develop alternative forms of therapy. That might be one reason antipsychotic prescriptions in B.C. are the lowest in Canada.
And five new 鈥測outh hubs鈥� are being set up to provide a walk-in service for youths aged 12 to 25. No physician referral is needed, and these storefront facilities will offer a range of services, from counselling to housing support.
But the fundamental problem is more basic. The pharmaceutical industry that manufactures these medications devotes little or no effort to testing them on children. That is a difficult and costly proposition, and anyway, the drugs aren鈥檛 meant for use on kids.
Governments in Canada likewise appear reluctant to encourage such research. Most of the studies that have been conducted were done abroad and provide limited guidance.
But why this puzzling lack of curiosity about what appears to be a major issue? Could it be that no one wants the responsibility of telling desperate families that their children aren鈥檛 benefiting from these treatments?
No one would suggest we stop entirely the use of antipsychotics for children in need. There is plenty of anecdotal evidence that some youngsters do benefit from this treatment.
Nevertheless, tens of thousands of kids are being given mind- and body-altering medications without adequate scientific basis, and in full knowledge that adverse effects are probable.
This is surely a research imperative that demands our attention. We must know what drugs are safe for our children.
The Health Ministry has made a good start. But more can, and must, be done.
