BRITISH COLUMBIA: Babies on psychiatric drugs
[Fred A. Baughman Jr., MD:
This is a perversion of science and a monstous perversion of medicine.
Once a study has been completed, presented at meetings, published in journals,
no matter how devoid of scientific merit, it becomes 'cutting edge', OK and
everyone starts doing it. There is no word for this except 'criminal'. The
District or prosecuting attorney of the province should convene a grand jury or
it's equivalent and begin to take testimony from physicians interviewed for
this article who have expressed alarm or misgiving. Testimony should be taken,
as well from child neurologists, pediatricians, pharmacologists, pediatric
pathologists, toxicologists and the like, then indictments should follow.
Wherever preschoolers are being drugged (there is no justification for calling
this treatment), legal inquiries should be launched.]
B.C. BABIES ON PAXIL, PROZAC, ZOLOFT Babies on mood drugs Tender age of patients shocks physicians Ann Rees The Vancouver Province 18 December 2000 Babies still young enough to be in diapers are being prescribed powerful adult tranquilizers. A Vancouver Province investigation found about 20 B.C. infants aged two and under last year were prescribed either a sedative called imipramine or anti-depressant drugs such as Prozac, Paxil and Zoloft, a class of drugs known as SSRIs. The five youngest were not even a year old, which shocked doctors. "Oh my goodness!" said Dr. Wendy Roberts, pediatrician and director of the Child Development Centre at Toronto's Hospital for Sick Children. Dr. Marshall Korenblum, chief psychiatrist at the prestigious Hincks-Dellcrest Centre for Children in Toronto said: "I cannot see any indication for putting a pre-schooler on anti-depressants." The drugs have not been tested for safety and effectiveness in such young children.
[Fred A. Baughman Jr., MD:
Meaning there is no proof they are safe or effective, i.e.,
that there is no medical reason to prescribe them.]
Dr. Jane Garland, head of the mood disorders clinic at B.C. Children's Hospital in Vancouver, said "systematic studies" have been done only on children six and up. But despite the lack of research, Garland said the drugs are appropriate in rare and extreme cases for children under three. "I have seen kids, for example, with sleep-terror disorders or extreme sleep disorders and anxiety problems who are younger than three who occasionally have been put on those medications," she said.
[Fred A. Baughman Jr., MD:
That someone
has done it is all they have to have to justify following suit. With no valid
research as to safety or efficacy it cannot be said their is a scientific basis
for using such drugs in children of this age. It cannot be said that that
benefit outweighs risks. This being the case, there is no justification for
their use.]
"But that would be a treatment of last resort for under-threes. One would have wanted to try everything else." Garland is currently conducting a drug trial, paid for by the manufacturer of the anti-depressant Zoloft, to study safety and effectiveness in six-to 18-year-olds.
[Fred A. Baughman Jr., MD:
With the 'researcher' funded by the drug's maker, what is the
chance the drug will be found to be other than effective?]
Meanwhile, there is widespread debate about whether popular anti-depressants could cause long-term side-effects, especially in young children. At the extreme end of the debate is a book called Prozac Backlash, in which Harvard psychiatrist Dr. Joseph Glenmullen documents serious long-term effects of popular anti-depressants such as Prozac, Paxil and Zoloft. Glenmullen reports several cases of neurological disorders, such as disfiguring facial and body tics, which he believes are indications of brain damage. Other prominent doctors have dismissed Glenmullen's concerns. But when it comes to children there is no certainty either way. "I think it's reasonable to be concerned," Julie Magno Zito, a University of Maryland pharmacy professor, said in a recent magazine interview. "We have no idea on how these drugs affect the developing brain, the heart, the kidney, the liver."
[Fred A. Baughman Jr., MD:
Which means there is no justification for giving
them--it simply is not known if they do more harm than good]
What is certain is that the use of psychiatric drugs by young children is on the increase.
[Fred A. Baughman Jr., MD:
Not treatment having a scientific basis for a bona fide disease or diseases, it is big business of the
mental health/psychopharm industry]
Zito recently published a study in which she found a three-fold increase in the prescription of psychotropic drugs in U.S. children aged two to four between 1991 and 1995. "It's a growth market," said Dr. Larry Diller, an American pediatrician who is writing a book urging a more sensible approach to using drugs to treat childhood psychiatric disorders. Diller, who wrote the best selling book Running on Ritalin, believes widespread acceptance of drugs to treat Attention Deficit Hyperactivity Disorder has made doctors and parents less cautious about using other psychiatric drugs to treat children. "I think it is just basically the increasing acceptance of using psychiatric drugs in children." B.C. appears to be on the cutting edge of the trend. The 20 babies and tots were among almost 70 pre-schoolers four and younger who were prescribed sedatives and anti-depressants last year, according to data obtained through Freedom of Information from B.C.'s PharmaNet prescription record system. The youngest anti-depressant patients were two baby girls and three baby boys, all under a year old. The two girls received Paxil. One baby boy was prescribed bupropion, a drug sold as Zyban and Wellbutrin, and the other two received Surmontil and Effexor. Three babies who turned one last year were also given Prozac, Paxil or trazodone. A dozen tots who turned two last year were also given anti-depressants. Five of the two-year-olds were prescribed imipramine, which the American Heart Association warns could cause death from cardiac arrest. Toronto's Roberts said doctors at Sick Children's are very cautious about using the sedative and never prescribe it for babies. "Not at that age, never," she said. "There are major cardiac problems with that." In the past, the drug was commonly prescribed in school-aged children to control bed-wetting. But there is absolutely no excuse for using a drug to control bed-wetting in a two-year- old, said Toronto psychiatrist Korenblum. "They may not even be toilet-trained yet," he said. Neither of the Toronto child specialists could explain why infants would be prescribed anti-depressants or sedatives. Roberts said anti-depressants such as Paxil, Prozac and Zoloft are used to treat children old enough to speak but who have a rare form of mutism associated with social anxiety. "The incidence is very small," she said. "I wouldn't think there would be 10 kids in B.C. with it." The same anti-depressants are used to treat autism, but usually not before age four or five. "Zoloft has been very helpful at night for a percentage of (autistic) kids because it has a sedating effect," Roberts said. "For some of our kids it is a lifesaver because they sleep two hours a night and the parents are just completely wiped out. It also helps the excessive anxious behaviour." Dr. Pratibha Reebye, infant psychiatrist at B.C.'s Children's Hospital, does not prescribe anti-depressants to kids under three.
[Fred A. Baughman Jr., MD:
It is absurd of psychiatry to pretend it can diagnose psychologic symptom
complexes in infancy
that are akin to those diagnosed and treated in children K-12, and in adults.
Moreover, once diagnosed, they presume as through all biological psychiatry,
that they have diagnosed a 'disease', a 'chemical imbalance', one needing
medical therapy--a 'chemical balancer', a pill.]
"But occasionally you may have a child who is three and a half years or four years old who is clinically so depressed and having phobic reactions, not sleeping, not settling down and you may want to try some anti-depressants. But that would be a very rare." Dr. Derryck Smith, chief psychiatrist at Children's Hospital does not know why a baby would be prescribed an anti-depressant. "There is no reason I could think of personally, but that is not to say there isn't one," said Smith. What the doc ordered Ann Rees Vancouver Province 18 December 2000 Paxil is the leading anti-depressant for kids in B.C. Doctors turn to Zoloft and Prozac as their second and third choices to treat depression, anxiety, obsessive-compulsive disorders and other mental disorders, according to 1999 data obtained through Freedom of Information from the provincial PharmaNet prescription drug records. The data does not show the diagnosis. About 3,326 teens and children were prescribed Zoloft which, like Paxil, is one of a new group of mood-altering anti-depressants called serotonin reuptake inhibitors (SSRIs). Two dozen Zoloft patients were six or younger, and about 420 were 12 or younger. Prozac, perhaps the best known of the SSRIs, was the third most popular tranquilizer for kids, with 2,498 patients under 19. About 464 of the patients were pre-teens. Fifty-five were six or younger. About 2,285 teens and children were prescribed imipramine, an old-style tricyclic anti-depressant. The drug, which is sold under the brand names Tofranil, Impril and Novo-Pramine, is used primarily to treat long-term depression. It was previously widely used to control bed-wetting. "We have stopped using it altogether unless you are completely desperate," said Dr. Wendy Roberts, director of the Child Development Clinic at Toronto's Hospital for Sick Children. In B.C., 42 of the patients were under five, and five of those turned two last year. Thousands of B.C. children and teenagers were prescribed other powerful anti-depressants which are not tested or recommended for use in young patients. The PharmaNet records show: - 1,966 patients 19 or younger received prescriptions for amitriptyline, which is sold under the brand names Elavil, Apo-Amitriptyline and Novo-Tryptin. The youngest patient was two years old, with 40 aged six years or younger and 171 aged 10 or younger. - 1,409 patients received fluvoxamine, sold as Luvox, which is used to treat depression and obsessive-compulsive disorder. The youngest patients were four years old, with 198 aged 10 or younger -- 30 were aged six or younger. - 1,380 patients aged 19 or younger received venlafaxine, an anti-depressant sold as Effexor. The youngest patient on the drug was under one year of age. Forty- nine patients were 10 or younger. - 1,310 received trazodone, which is sold as Desyrel. The youngest patient was a one-year-old infant; 17 were six or younger and there were 106 patients 10 or younger. - 946 received bupropion, which is sold as Zyban and Wellbutrin. The youngest patient was under one year, with 65 aged 10 years or younger -- five were six or younger. - 533 received citalopram hydrobromide, sold as Celexa. The youngest was seven. - 351 received clomipramine, sold as Apo-clomipramine and Anafranil. The youngest turned seven last year. - 275 received desipramine, sold as Norpramin and Pertofane. The anti-depressant is not recommended for children under 12. The data shows 91 children under 12 were prescribed the drug in 1999. The youngest was four last year. - 243 received Lithium, an anti-manic drug which carries a high overdose risk as well as side-effects of nausea and trembling. Only 12 patients were 10 or older. The youngest was six. - 200 received doxepin, an anti-depressant with strong sedative effects. The youngest patient was four. A child who turned five and two who were six last year were also on the drug. - 321 received nefazodone, an anti-depressant. Only nine patients were under 10, with the youngest aged four. - 159 received nortriptyline, an old-style tricyclic anti-depressant sold as Aventyl. There were 23 patients aged 10 or under on the drug, with the youngest patient turning five last year. - 91 patients received moclobemide, an anti-depressant sold as Manerix. The youngest three patients were eight in 1999. - 67 patients received trimipramine, which is an anti-depressant sold as Surmontil. Two of the patients were infants younger than a year.