2008-09-25 02:15:48
Wed Sep 24, 9:09 PM ET
Youngsters in the United States are three times likelier to be prescribed
antidepressants and stimulants and twice as likely to be given antipsychotic
drugs than counterparts in Germany and the Netherlands, according to a new
study.
The use of antidepressants and stimulants such as Prozac and Ritalin to treat
hyperactivity, attention deficit and bipolar disorders in teenagers and young
children has become a subject of sharp controversy.
Proponents say these powerful drugs, known as psychotropics, target newly
identified conditions that were undertreated or misdiagnosed in the past.
Critics say the medications are being used too broadly, addressing behavioural
problems that should be tackled by softer therapies.
Drawing from data on nearly 600,000 youngsters 19 years old and younger, the
study is one of the first rigorous comparisons across several countries of how
these medications are dispensed among the young.
In 2000, nearly seven percent of children in the US took psychotropics of some
kind, while 2.9 and 2.0 percent, respectively, did so in the Netherlands and
Germany, according to the study.
One in 12 of American children aged five to nine were taking these medications,
four times the European levels.
Lead researcher Julie Zito, a University of Maryland pharmacologist, said
psychotropic use in the United States may have increased since the data was
collected.
"The US trends appear to be continuing," she told AFP in an email.
Seeking explanations for the disparity on either side of the Atlantic, the
study noted that direct-to-consumer drug advertising was allowed in the United
States, but banned in Europe.
Cultural differences could also play a role, they suggest.
"The increased use of medication in the US reflects the individualist and
activist therapeutic mentality of US medical culture," Zito said.
There are also differences in the way behavioural disorders are defined and
classified.
The diagnosis of "hyperkinetic disorder" in the European medical system, for
example, is more stringent than that of the "attention deficit hyperactivity
disorder" (ADHD), the equivalent syndrome in the US classification.
Another difference is who is handing out the medication: there are more
psychiatrists per capita in the United States, which could influence
prescription patterns, the study says.
Reimbursement policies and government regulatory constraints may also be
factors.
Amphetamines and other stimulants are rarely prescribed for children in Western
Europe. In France, their use was banned during the period covered by the study,
1999 and 2000.
Government health plans in Europe have also cut down on the use of expensive,
patent-protected drugs, especially antipsychotics and antidepressants.
The study was published online, on Thursday, in the British-based open access
journal BioMed Central.