Newspaper calls on State to do something about Antipsychotic Drugging of Children

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" 40 percent of the antipsychotics prescribed to Florida Medicaid

children were given to children diagnosed with ADHD -- a use not

approved by the Food and Drug Administration " ... Daytona Beach News

Journal, January 10, 2008

Daytona Beach News Journal

Editorial: Drugs for children? Prescriptions of anti-psychotics

troubling

January 16, 2008

Parents at their wits' end, wearing long sleeves to hide bruises and

bite marks inflicted by their own offspring. Psychiatrists struggling to

cope with children as young as 2 who show intractable behavior problems.

Drug companies ready to suggest powerful drugs that can produce marked

changes in a child's behavior -- getting heavily involved in state-level

determinations of which drugs should be prescribed for which conditions.

And a state struggling to keep up with rapid changes that have pushed

Medicaid costs for powerful anti-psychotic drugs from $9 million seven

years ago to almost $30 million in 2006.

Something doesn't add up. Do all these children need the drugs they're

being prescribed? Without a careful review of individual medical

records, it's difficult to say -- but the trend is disturbing. Other

states are already pushing hard for answers, and Florida should join in.

The drugs in question are known as atypical anti-psychotics and include

Risperdal, Abilify, Geodon and Seroquel. Originally intended to treat

major mental illnesses like schizophrenia and bipolar mania, they have

become increasingly widely prescribed for children with autism and

attention-deficit disorder with tics.

Yet, the U.S. Food and Drug Administration has approved few of these

drugs for use with children -- especially in conjunction with many of

the conditions for which the powerful drugs are prescribed. There's

little research on the effects of the drugs, and a growing number of

reports suggest that the medication could be responsible for deaths or

serious side effects, including tardive dyskenisa (involuntary jerking

of the limbs and grimacing).

State Medicaid programs across the country have found themselves paying

for increasing quantities of these drugs. In Florida, the number of

child Medicaid recipients taking atypical anti-psychotics has doubled

since 1999, despite a lack of evidence suggesting that they're any more

effective than other cheaper drugs.

Twenty-six states are exploring legal action against drug companies for

unfair trade practices or consumer-protection violations (Florida is one

of them; the Attorney General's Medicaid Fraud Control Unit served drug

manufacturer Eli Lilly with a request in 2005 for information regarding

its marketing of the drug Zyprexa.) Other states are being more

aggressive; several have actually filed suit seeking to reclaim some of

the millions spent on these drugs.

But Florida owes a more important duty to the thousands of children

across the state who are taking powerful medications. Immediately

discontinuing Medicaid reimbursement for the medications would be a

mistake -- too many children are currently stabilized on drugs and might

actually be benefiting. But the state should move to develop better

standards for when the drugs should be prescribed. And this time around,

the state should look first to public-health officials and the FDA.

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