Incomprehensibly Irresponsible: Brain Drugs and Babies

Laurie and Debbie say:

In 2008, we wrote “The Medicalization of Human Variety,” about how concerned we (and much of the medical establishment) were about the increase in prescribing Ritalin and other psychoactive drugs to schoolchildren.  We are shocked and saddened to find out how much worse things have gotten in the last seven years.


Alan Schwarz, writing in the New York Times, details much nastier drugs than Ritalin, such as the antipsychotic risperidone (Risperdal) given to babies and toddlers. Schwarz reports “almost 20,000” such prescriptions were written in 2014,  a 50% jump from 2013. Prozac prescriptions for children that young are rising almost as fast.

We can’t even count the number of ways that this is horrible.

Brain science is itself in its infancy. Virtually all of the psychoactive medications prescribed today work by guesswork and hypothesis. We might know that a drug raises serotonin levels or reduces cortisol, but no one really understands why or how those chemical changes affect mood, behavior, resilience, et cetera. And no one understands what else these chemicals might be doing to the brain.

Whatever we do know about brains we know about adult brains. Children’s brains are incredibly plastic, growing at phenomenal speeds, and very little studied. In the case of Ritalin, it took medical scientists decades to understand that it affects children exactly the opposite way it affects adults. With newer drugs like Risperdal and even Prozac, the effects are unpredictable and could certainly be the opposite of what the prescribing doctor intends. Since we can’t ethically, morally, or as human beings experiment on living children to find out what works, this study has to proceed extraordinarily slowly and carefully.

… Dr. [Mary Margaret] Gleason, [a pediatrician and child psychiatrist at Tulane University] said that children with ages measured in months had brains whose neurological inner workings were developing too rapidly, and in still unknown ways, to risk using medications that can profoundly influence that growth. She said the medications had never been subject to formal clinical trials in infants and toddlers largely because of those dangers.

“There are not studies,” Dr. Gleason said, “and I’m not pushing for them.”

Perhaps most important, while some percentage of the children receiving these drugs have some kind of medical need that the drug at least might address, many of them are just behaving like children their age.  Schwarz uses the phrase “tempering chronically disruptive behavior,” which is easy-to-read code for “This kid is hard to manage.”

“There are behavioral ways of working with the problems rather than medication,” said Dr. [Ed] Tronick, [a professor of developmental and brain sciences at the University of Massachusetts Boston], who runs a program that teaches health care providers to assist families with troubled children. “What is generating such fear and anger and withdrawal in the child? What is frustrating or causing stress in the parent? These are the things that have to be explored. But that takes time and money.”

He also said something we said back in that 2008 post:

There’s this very narrow range of what people think the prototype child should look like. Deviations from that lead them to seek out interventions like these.

These kinds of “interventions,” these drug-based “solutions” to behavior that can almost certainly be addressed with patience, creativity, love, and (when appropriate) therapy, can destroy a child’s life, destroy a family’s life, and damage everyone who cares about that child and family.

It’s bad enough that these drugs are officially available to children in the 8-10 range depending on the drug. It’s bad enough (though completely not surprising) that the pharmaceutical companies getting rich off the drugs have stories of “positive effects among suffering young people” they can tell to line their pockets. Some of those stories are probably true, but you can bet your last dollar that they are cherry-picked from a set of mostly miserable-to-neutral stories. What’s worse is that too many people don’t care about our society’s children enough to protect them from harmful chemical intervention; we just want them to shut up, behave right, and not bother anybody.

Children are a global treasure; they’re the hope we have. They have a right to grow up whole and complete and uninvaded.


5 thoughts on “Incomprehensibly Irresponsible: Brain Drugs and Babies

  1. This is very disturbing. I happen to know that Risperdal, an anti-psychotic drug, was the subject of some significant litigation by state attorneys general in the US because it was being over-prescribed to elderly patients. That was about the states having to pay too much money, but there was an indication that it was often being used in situations that didn’t warrant it. The idea of using that drug in babies and toddlers is just appalling.

    I recommend Steve Silberman’s book NeuroTribes on the subject of neurodiversity and the importance of recognizing — not medicalizing — the many variations of the human brain.

    1. Lisa and Nancy,

      Yes, all the evidence points to how bad an idea this is!

      Lisa, my data is old; I’ll have to review. I thought it shifted even with ADHD in the late teenage years, but I can’t say that I know for sure.

  2. More fuel for the fire: An article in the Times mentions that kids with poor vision are sometimes misdiagnosed with ADHD and put on drugs:

    This is a wholly unnecessary consequence of gaps in medical coverage and the general failure to make sure kids are screened for vision and hearing loss as early as possible.

    I thought the deal with Ritalin is that stimulants have a calming effect on all persons with ADHD, which is the opposite of how stimulants work in people who don’t, but you mention that it’s age related?

  3. And then there is the over medicating of youth in foster care, across the board.
    The cocktails that some are given, especially in group home or residential treatment centers, are terrifying. At best. This Government Accounting Office highlights touches all your concerns — 2011.

    1. Jeanne,

      Damn, you write about this kind of horrible thing and then you find out how much worse it is than you thought! Thanks for the info, we say wryly.

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