When prescribed by a specialist and taken as directed, antidepressant and antipsychotic medications can make a life-changing difference in the lives of children with significant mental health disorders, and their families. However, a recent uptick in the use of these drugs for younger children has experts concerned.
“When children younger than 3 years old are prescribed antipsychotic medications and antidepressant medications, it is very concerning,” says Dr. Sanjoy Sathpathy, a child and adolescent psychiatrist and clinical director of child inpatient services at Sharp Mesa Vista Hospital. “It’s concerning to me as a parent, as well as a physician.”
“These medications were never meant to be used in this young population,” he says. “They have severe side effects that could be disturbing, considering their young age and their potential to grow.”
Many of the most common antidepressants and antipsychotics are not approved by the FDA for use in children or are only approved for children over the age of 6. Still, a growing number of doctors are prescribing them for “off-label” use in cases of attention deficit/hyperactivity disorder (ADHD) and behavioral problems.
A 2014 report by the Centers for Disease Control and Prevention (CDC) found that doctors and other health care providers wrote more than 10,000 off-label prescriptions for children diagnosed with ADHD at ages 2 and 3. There are no guidelines or position statements on the use of antidepressants and antipsychotics in children that young from either the American Academy of Pediatrics or the American Academy of Child and Adolescent Psychology.
Given the potential for overuse, and the effect these powerful drugs could have on growing bodies and minds, the American Psychiatric Association announced in 2013 that doctors should not routinely prescribe the drugs as first-line treatment to children and adolescents for any reason other than psychotic disorders, such as schizophrenia or severe tic disorders.
Dr. Sathpathy worries that parents aren’t seeking the help of licensed mental health experts when they have concerns about the behavior of their young children.
“It’s important for parents to heed their own concerns,” he says. “If parents are worried about their children, they need to talk about it to their pediatrician. In turn, their pediatrician should have access to refer them to a specialist like a child psychiatrist. At this early age, it’s important that these types of concerns should be addressed by a specialist.”