October 2009
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Millions of U.S. children
are taking psychiatric drugs, most never tested on kids.
Good medicine - or uncontrolled experiment? |
In recent years, there's been a dramatic increase in the number of
children being diagnosed with serious psychiatric disorders and
prescribed medications that are just beginning to be tested in
children.
The drugs can cause serious side effects, and virtually
nothing is known about their long-term impact.
"It's really to some
extent an experiment, trying medications in these children of this
age," child psychiatrist Dr. Patrick Bacon tells FRONTLINE. "It's a
gamble. And I tell parents there's no way to know what's going to
work."
In The Medicated Child, FRONTLINE producer
Marcela Gaviria confronts
psychiatrists, researchers and government regulators about the
risks, benefits and many questions surrounding prescription drugs
for troubled children.
The biggest current controversy surrounds the
diagnosis of bipolar disorder.
Formerly called manic depression,
bipolar disorder was long believed to exist only in adults. But in
the mid-1990s, bipolar in children began to be diagnosed at much
higher rates, sometimes in kids as young as 4 years old.
"The rates
of bipolar diagnoses in children have increased markedly in many
communities over the last five to seven years," says Dr. Steven
Hyman, a former director of the National Institute of Mental Health.
"I think the real question is, are those diagnoses right? And in
truth, I don't think we yet know the answer."
Like many of the 1 million children now diagnosed with bipolar,
5-year-old Jacob Solomon was initially believed to suffer from an
attention deficit disorder.
His parents reluctantly started him on
Ritalin, but over the next five years, Jacob would be put on one
drug after another.
"It all started to feel out of control," Jacob's
father, Ron, told FRONTLINE.
"Nobody ever said we can work with this
through therapy and things like that. Everywhere we looked it was,
'Take meds, take meds, take meds.'"
Over the years, Jacob's multiple medications have helped improve his
mood, but they've also left him with a severe tic in his neck which
doctors are having trouble fully explaining.
"We're dealing with
developing minds and brains, and medications have a whole different
impact in the young developing child than they do in an adult," says
Dr. Marianne Wamboldt, the chief of psychiatry at Denver Children's
Hospital.
"We don't understand that impact very well. That's where
we're still in the Dark Ages."
DJ Koontz was diagnosed with bipolar at 4 years old, after his
temper tantrums became more frequent and explosive.
He was recently
prescribed powerful antipsychotic drugs.
"It is a little worrisome
to me because he is so young," says DJ's mother, Christine. "If he
didn't take it, though, I don't know if we could function as a
family. It's almost a do-or-die situation over here."
DJ's medicines
seem to be helping him in the short run, but the longer-term outlook
is still uncertain.
"What's not really clear is whether many of the
kids who are called bipolar have anything that's related to this
very well-studied disorder in adults," says Dr. Thomas Insel, the
director of the National Institute of Mental Health.
"It's not clear
that people with that adult illness started with what we're now
calling bipolar in children. Nor is it clear that the kids who have
this disorder are going to grow up to have what we used to call
manic-depressive illness in adulthood."
While some urge caution when it comes to bipolar in children,
FRONTLINE talks with others who argue that we should intervene with
drug treatments at even younger ages for children genetically
predisposed to the disorder.
"The theory is that if you get in
early, before the first full mood episode, then perhaps we can delay
the onset to full mania," says Dr. Kiki Chang of Stanford
University. "And if that's the case, perhaps finding the right
medication early on can protect a brain so that these children never
do progress to full bipolar disorder."
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