Proponents believe that children clear medications from their bodies quicker, thus leading to less physical addiction. This may or may not be true. Nevertheless, there is still the unresolved matter of potential psychological and spiritual damage from taking psychotropic medicines.
Giving children medicine at the first sign of a problem, whether paracetamol for a headache or Prozac for a bad mood, sends a powerful message to the youthful mind - pills will cure your ills. It’s a message that drug companies would like to see embedded in all of our minds.
In fact, it is the hidden damage of early drug use that is most difficult to spot and remedy. Early childhood is a time of tremendous changes in the human brain. Cerebral metabolic rate peaks between ages three and four (Ann Neurol, 1987; 22: 487-97), and visual processing, language and motor skills are acquired at this time. The influence of mind-altering medications on the timing and direction of physical and mental development is simply not known (J Am Acad Child Adolesc Psychiatry, 2003; 42: 651-5).
For this reason, a recent review (JAMA, 2000; 283: 1025-30) concluded that the 'possibility of adverse effects on the developing brain cannot be ruled out'. The report’s authors then went on to recommend that now is the time for parents to start actively looking for signs of subtle changes in the developing personalities of their children, which could be the direct result of mood-altering drugs on the neurotransmitters of the brain.
Barriers to change
Many things stand in the way of effective medical treatment for children. One is the ethical issue of testing drugs in children. What parents, after all, would consent to such participation and potential harm of their child?
Yet, the extensive off-label use of medications in children suggests that many are already participating in such research (J Law Med Ethics, 2000; 28: 362-78).
Also, paediatric drug use traditionally represents only a small portion of the market, so there is little incentive for paediatric drug testing. To comply with current regulations, drug companies need only insert a disclaimer, cautioning against paediatric use.
Even so, a review by Australian authorities found that 70 per cent of the products surveyed had either no information, or only a partial or general disclaimer regarding use in children (Report of the Working Party on the Registration of Drugs for Use in Children, Canberra: Therapeutic Goods Administration, 1997). This finding is similar to that of the US Physicians’ Desk Reference (Pediatrics, 1999; 104: 598-602).
Clearly, whatever the official line, children do not have equal access to ‘safe’ regulated drugs. But other socially based problems have promoted the acceptance of the use of mood-altering drugs by children.
Chief among these is how parents are continually being encouraged to abdicate their parental responsibilities to doctors, schools, social services officials and, ultimately, drug companies.
There is also the growing belief, unique to the post-baby-boomer generation of parents, that all children must fit into an idealised behavioural picture - well behaved, uncomplaining, never bored or fussy and never an inconvenience to the parents. The more widespread this expectation, the more children will be diagnosed with ‘behavioural problems’ and ‘depression’.
The backlash against Ritalin and overdiagnosis of ADHD may also be a factor. Parents unhappy with the ‘diagnosis’ of ADHD have successfully argued that the symptoms of ADHD can be easily confused with other problems.