Grown-ups and kids are different in some ways, and one of them appears to be how they react to atypical antipsychotics. These drugs are also known as second-generation antipsychotics, and they have pretty much replaced first-generation antipsychotics. There isn’t much difference, but the difference is an important one: with SGAs, the patient is less likely to suffer from movement disorders.
SGAs are prescribed to treat schizophrenia, autism, bipolar disorder, and major depressive disorder. It looks like kids are more likely to gain weight with these drugs, to the point of entering the overweight or obese range. Or, to quote Dr. Mary Ann E. Zagaria of Nurse Practitioner World News,
With the increasingly widespread use of SGAs, clinicians are facing more and more cases of SGA-associated disruptions in metabolic function manifested by weight gain, dyslipidemia, and hyperglycemia, including new-onset type 2 diabetes mellitus (DM).
In other words, whether they are strictly needed or not to solve already existing problems, these drugs can cause even more problems. Clozapine and Olanzapine are the worst in that respect. Dr. Zagaria notes that weight gain is a side effect commonly found when antipsychotics are taken by either adults or children.
In the United Kingdom, the treatment of children with antidepressants was discontinued in 2003, we are told by Andrew M. Weiss, who has served on the faculty of Iona College and whose field is technology in education. He is interested in the number of babies, children, and youth in the United States who routinely take legal psychotropic drugs. Weiss writes,
Common population estimates include at least eight million children, ages two to eighteen, receiving prescriptions for ADD, ADHD, bipolar disorder, autism, simple depression, schizophrenia, and the dozens of other disorders now included in psychiatric classification manuals… Today, the total toddler count is well past one million, and influential psychiatrists have insisted that mental health prescriptions are appropriate for children as young as twelve months.
One school of thought characterizes this as “hyper-medicalizing.” According to its philosophy, mind-altering substances should only be a very last resort in the most complicated and difficult cases. People who subscribe to this kind of thinking can admit the possibility that maybe one child in a thousand might require psychotropic medication. They are just not comfortable with a mainstream medical environment where nearly one child in 10 is “on something.”
The differing attitudes toward these particular pediatric pharmaceuticals are a classic case of interests in conflict. The involved parties are parents, doctors, pharmaceutical companies, the government and, of course, the children. Their needs and wants are not always in alignment. Who will ultimately have the privilege to decide how much medicalizing is too much medicalizing?
Every individual prescription of a psychotropic drug presents its own set of conflicts of interest. In regard to the original problem and symptoms, the patient’s condition might improve. On the other hand, the patient might develop side effects like tardive dyskinesia, or involuntary repetitive movements. This sort of behavior brands a kid as a spazz and is a guaranteed bully magnet. Another potential side effect is a life-threatening disorder of the white blood cells.
The medication might cause slurred speech and impaired balance, or even narcolepsy. Being arrested for public intoxication is an undesirable side effect, and so is falling asleep at the wheel of a car, or while waiting for the subway. This is why the conscientious professional follows up and adjusts the dosage if necessary, to fine-tune and minimize the side effects. Weiss says,
The attempt to control these side effects has resulted in many children taking as many as eight additional drugs every day, but in many cases, this has only compounded the problem. Each ‘helper’ drug produces unwanted side effects of its own.
The bottom line here is that an awful lot of children are taking an awful lot of medications, and some of those drugs are proven to cause various side effects including weight gain, and weight gain can even become obesity. The psycho-pharmaceutical environment that makes this possible is just another element of the Childhood Obesity Perfect Storm.
Your responses and feedback are welcome!
Source: “Antipsychotic-associated Metabolic and Cardiovascular Risks,” Nurse Practitioner World News, 03/11
Source: “The Wholesale Sedation of America’s Youth,” CSICOP.org, 12/08
Image by colros (Sandra Cohen-Rose and Colin Rose), used under its Creative Commons license.