It's only fair to share…

It is with some shock that I discovered that a pharmaceutical company is doing a trial of antidepressant use in children as young as seven. The stated purpose of the trial is to compare Paxil to placebo for eight weeks in children and adolescents aged seven through seventeen.

As Will Ferrell’s Mugatu character in Zoolander said, I feel like I am taking crazy pills. Why such a trial would be done and how it got ethics approval is beyond me. The list of exclusions and who can be included is fascinating by itself. That the trial is meant to show something in eight weeks when these medications are not thought to take any effect for a few weeks is staggering too.

Above all else though is the notion of diagnosing diseases like depression in children of this age. Children may well feel sad for a variety of reasons but labeling that as depression is another matter and to then prescribe antidepressants to developing brains is not acceptable in my book.

Yet, other reports describe children as the leading growth demographic for the pharmaceutical industry. Reuters reports that over one in four insured children were on at least one prescription medication for a chronic condition. The main increases were in treatments for diabetes, for ADHD, and the use of antipsychotics. Whilst use of antidepressants is actually in decline following FDA warnings about suicide, use of antipsychotic medication has climbed. Indeed it has doubled since 2001. These are potent medications in adults let alone for developing brains.

There is a saying about how when the only tool you have is a hammer how all problems start to look like nails. It is claimed that 21% of American children and adolescents have a “diagnosable mental illness”. A recommendation to pediatricians in the USA to screen children for mental health issues at every doctors visit has been made.

What total nonsense. Of course if you go looking to convert children’s emotions into “diagnosable conditions” you will be able to find them. In turn if your only tool is a drug (instead of a hammer) all the issues the children have will look like nails, which require drugs.

At the same time a new study has shown that one third of children diagnosed with ADHD have other problems. Of course the weasel term of co morbidity (they have two problems) gets raised here. My favorite is oppositional defiance disorder, which is essentially the “diagnosable mental illness” of children not doing what they are told. Furthermore in half of those diagnosed with ADHD there are social and environmental factors, which explain the behaviors, which are seen and then “labeled” and drugged. Again the hammer and nail approach.

Here is the bottom line. Children may have a variety of heath and emotional problems. They need our help, support and guidance, not labels and drugs. In the same way that not all problems are nails and solved by a hammer, not all problems children have are medical ones requiring a drug?