Psychological medication use has been slowly creeping into younger and younger age groups, and it’s becoming increasingly common to encounter preschoolers who have been put on psychiatric or behavioral medication. A 2008 analysis by Mathematica found that in 2008, 19,045 children age 5 and under were prescribed antipsychotics through Medicaid, up from 7,759 in 1999. This represented 3% of all Medicaid recipients under 20. (Lagnado, 2013) This trend is concerning on several counts:
-
It represents a seriously distorted world view. Preschoolers are supposed to be moody and rambunctious. The idea that these traits are now being considered abnormal speaks more to the mental illness of adults than it does the children. Equally as absurd is the idea that problems in a preschool child are about flaws in the child as opposed to flaws in their caretakers or overall environment.
-
Starting these drugs at such an early age has the potential to profoundly alter their development. We’re taking normal brains and creating chemical imbalances that will plague that child well into the future.
-
Due to their smaller size and higher metabolism, there’s a greater likelihood of serious and potentially deadly side effects.
The folly of putting preschoolers on drugs
There’s also little to no evidence showing these drugs actually work as intended. An Oregon State University Review characterized the evidence of effectiveness for psychiatric medications in the preschool age group in the following way:
- Stimulants: Fair
- Mood stabilizers: Poor
- Atypical antipsychotics: Poor
- Antidepressants: Poor
- Two or more psychotic drugs used at once (polypharmacy): Poor
- Three or more at once: None
- PRN use of psychotropics: None
This is hardly a ringing endorsement in support of doping up our preschoolers. They conclude that “There is limited evidence to support the use of psychotropics in pre-school children (stimulants for ADHD, risperdal for autism, lithium for BPD).” (OSU, 2008) Another study by Biederman et al. (2005) tested the popular mood-stabilizing drugs risperdone and olanzapine in 31 preschool children with bipolar disorder ( a controversial diagnosis to begin with). Although it did seem to slightly reduce their “symptoms,” there were substantial adverse effects. The team concluded that the risks may outweigh any benefits.
Moreover, any slight benefit you might achieve is going to be substantially outweighed by the benefit you would get from non-pharmaceutical interventions. So we need to stop being lazy and actually help our kids rather than merely trying to drug them into submission.