First, let me say that I totally believe that medication is necessary for some children with some disorders. I believe that children can have psychiatric disorders and behavioral disorders, and emotional disorders — some of which are very appropriately treated by medication. If your kid is one with a severe disorder, I am not talking to you. Well, I am, but I am not criticizing you. If your kid has something like ADHD and is taking medication intended to treat that disorder, I am also not talking to you … well, I am talking to you … never mind.
What I am talking about is the number of kids that I see on antipsychotic medications. I see a LOT of kids on a lot of medications. I do evaluations and I see a fair amount of children with behavior problems. The most common diagnosis that I see is ADHD — and I would say that more than half of those kids that are diagnosed with it are likely to have the disorder. I would not say that medication is inappropriate in those cases. I wonder, sometimes, what other behavioral strategies would be helpful for those kids, but hey — I am not their parent. I am not being called by the school every day and being told to come get Johnny or Janey out of class because the teacher cannot handle the disruption. I don’t have to attend endless conferences where the not so subtle message is that I cannot control my kid. So, I cannot speak to those parents. But I will say that for some kids, medication for ADHD is like a miracle. They will tell you themselves that they can now concentrate and aren’t getting in trouble all of the time. I am not medication-bashing.
I have been doing child evaluations for about eight years now and the thing that has been striking is the increase in the number of children that I see with relatively benign disorders (such as ADHD — and yeah, I said RELATIVELY benign) on heavy-duty medications. And I am not saying that you can’t give drugs to kids unless they have been tested on kids, because few medications are ever tested on kids. Would you sign your four year old for drug trials? Yeah. But, wow. I see a lot of kids on adult medications.
Zyprexa. Risperdal. Geodon. Abilify.
But mostly Risperdal. Risperdal is a medication to treat psychotic disorders and has been found to be useful in helping children with autism, Asperger’s and kids with some developmental delays. When I say helping them, mostly what it seems to do is to calm them down, which is not surprising, given the drug’s sedating effects.
I saw a kid the other day who was diagnosed with bipolar disorder at the age of five. He is currently diagnosed with ADHD and bipolar disorder — and was not given medication that would be consistent with either disorder. At the age of eight, he is now on an antipsychotic and a medication that lowers blood pressure. The second medication is being prescribed more and more frequently as an adjunct to medication for ADHD. But I have never seen it prescribed for ADHD alone.
Today, I saw an eight year old on Risperdal. Again, his behavior is clearly problematic, but I really wonder why he is being prescribed the medication. Is it to help him sleep? Aren’t there better sleep medications? He doesn’t seem to have sleep problems, from what the mom says.
What I am trying to say is that I see kids ALL THE TIME who are on lots and lots of medication. And I really wonder what is going on. It just feels, sometimes, that we are drugging our children to make them less bothersome. And I stand from my lofty height of having kids who are really not bothersome at all, so I get that I am probably speaking out of turn …
But man, I see a lot of kids on a lot of drugs that were never meant for children.
Anyway. I think it is a problem. I think the mindset is a problem. Schools have never been the most forgiving of places for a kid who has trouble controlling his or her behavior, but I sometimes feel like we are using chemical straight-jackets on the kids. An adult can say that they don’t want to take meds, but a child can’t. Not that they should have that authority, but doesn’t this feel weird to anyone but me? Doesn’t this feel wrong to anyone?