Dangers of pediatric polypharmacy for psychiatric symptoms

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Mon, 01 Aug 2005 23:35:52 -0000

[drugawareness] Dangers of pediatric polypharmacy for

psychiatric symptoms

 

 

 

 

 

http://i-newswire.com/pr39639.html

 

Providence, RI – Pediatric polypharmacy, the practice of

prescribing

two or more medications for psychiatric symptoms in children, is on

the rise in the United States, raising concern about unknown side

effects, according to a new study appearing in the August issue of

the journal Psychiatry 2005.

 

 

(I-Newswire) - " This is a critical issue - it's not uncommon to find

a child on an anti-depressant, a mood stabilizer, and a sleep agent

all at the same time, but there's no research to see how these drugs

interact with each other " says co-author Joseph Penn, MD a child

psychiatrist with the Bradley Hasbro Children's Research Center (

BHCRC ) in Providence, RI and Brown Medical School.

 

The authors reviewed 10 years of scholarly articles pertaining to

polypharmacy in pediatric settings, and found that all the studies

comparing these rates across time showed an increase in the practice.

 

However, the authors warn there are almost no studies or published

research on which to justify prescribing multiple medications for

psychiatric disorders in children.

 

According to the study, the most frequent combination were stimulants

such as methylphenidate ( Ritalin ) or dextroamphetamine ( Dexedrine,

Adderall ) commonly used to treat ADHD, with another psychotropic

medication.

 

Another contributing factor to the increased risks of prescribing

multiple drugs is the prevalence of off-label prescriptions – the

practice of prescribing a medication to children when there is not a

FDA approved indication for that disorder in children.

 

" For example, aytpicals like risperidone are sometimes used to

symptomatically treat psychosis or aggression in children, but most

of these medications don't have FDA approval for use on psychiatric

symptoms in the pediatric age group, " says co-author Henrietta

Leonard, MD, a child psychiatrist with the Bradley Hasbro Children's

Research Center and Brown Medical School. " We just don't have the

efficacy or safety data to back up what is common clinical practice. "

 

Because there are limits to the data available on the efficacy of a

single medication in the pediatric age group, the authors express

deep concern over the rise in polypharmacy because it could multiply

the risk of adverse events.

 

" The FDA recently questioned whether there is a link between the use

of antidepressants in children and suicidal thoughts – if there

is so

much concern over the effects of a single drug, how much riskier is

it to prescribe multiple drugs? " Penn says.

 

The authors cite examples of a child on two medications for ADHD who

died suddenly, and additionally describe serotonin syndrome, a

serious and potentially fatal illness that can result when a child

receives two medications with serotonergic properties.

 

In addition, the American Academy of Child and Adolescent Psychiatry

( AACAP ) has issued a policy statement saying, " Little data exist to

support advantageous efficacy for drug combinations, used primarily

to treat co-morbid conditions. "

 

The authors concur. " We need more systematic studies to establish the

safety and efficacy of medications in the pediatric age group, " says

Penn.

 

 

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