One of the best arguments against using psychotropics with children is this: They simply don’t work. The bulk of the independent research that’s been done on these medications shows them to be rather useless…no better than a placebo in many cases. When they do show a benefit, these benefits are rather small. While statistically significant in a research paper, most would amount to a real-world impact that is less than impressive; for instance, the equivalent of answering one question better on a 30-question psychological survey.
How effective are psychological medications and mood altering drugs when it comes to children?
If you read the previous section, you’re familiar with the rather shaky basis of psychological medications. There’s even more reason to be cautious when it comes to children, whose developing brains are even more susceptible to a drug’s effects and for whom there’s even less evidence of efficacy. (Drug trials rarely involve children, since they are harder to recruit and more difficult to administer. But unfortunately, this also means millions of children receive drugs that have never been tested or approved specifically for children.)
A recent report in the Oregon DVR Board newsletter that analyzed the research on this topic sums up the evidence of the efficacy of various drugs in children as follows:
Drug class Evidence of effectiveness
- 1. Stimulants Fair
- 2. Mood stabilizers Poor
- 3. Atypical antipsychotics Poor
- 4. Antidepressants Poor
- 5. Two psychotropic drugs used at once Poor
- 6. 3 or more used at once (Aebi, 2009) No evidence at all
This is hardly a ringing endorsement for these commonly prescribed drugs, and parents need to know just how baseless the alleged benefits are before they go shoving these pills down their child’s throat.
The effectiveness of autism drugs
Medications used for autism are even more of a gamble. Since we have no idea what autism is, any medication to try and treat it is little more than a shot in the dark. Autism is generally treated with antipsychotics (the newer ones which were formerly called “major tranquilizers”) which may sedate a child but do absolutely nothing to address underlying symptoms. (Szabo, 4-4-2011)
The difference between working and helping
Another thing all people need to understand is that just because you feel a drug, that doesn’t mean it’s working as intended. For example, people are prescribed a mood altering drug. So they take it and they feel different…their mood has been altered. But just because your mood has been altered, that doesn’t mean it’s been altered in a beneficial way or that a child is any better off. For example, I could snort cocaine and my mood would be altered. But would it be altered in a beneficial way? Would this altered mood help me live life more successfully? Would it solve my underlying problems? There’s a fundamental difference between a drug working and a drug helping.
Parents who give their children behavioral medications probably assume that these nuances between working and helping have already been sorted out. They would be wrong. Actually, the evidential basis for most psychotropic drugs amounts to the medical equivalent of trying to fix a computer by hitting it with a hammer: it’s a matter of, “let’s hit a child’s brain with this drug and see what happens.”
For example, we know that serotonin is a mood-regulating chemical. We know that, generally speaking, serotonin is one of many chemicals secreted when people feel happy or content. But using drugs that target serotonin to treat depression (as is widely being done) is a big leap of faith. For one, studies on depression have failed to turn up a link between serotonin levels and depression. In other words, people with depression are not deficient or lacking in serotonin; across the board their serotonin levels are no different than that of you or I. So hitting a child with higher levels of serotonin to treat depression is like dumping more gas into a car that already has a full tank in the hopes that this extra jolt might help it run better.
Most psychiatric drugs are simply synthetic neurotransmitters that have never been convincingly linked to any condition in particular. This is also why psychotropic drugs are so commonly cross-prescribed for many different conditions and used for all sorts of off-label purposes. When one hammer doesn’t work, doctors simply switch to a different drug and hope that this tool might do the trick. Maybe they switch from an “antidepressant” to an “antipsychotic” (all deceiving labels), believing that if loading a child’s brain with serotonin has failed to fix the problem, maybe doping them up on dopamine will achieve results. But essentially, all they’re doing is knocking a child’s brain with a hammer and hoping that something good happens.