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Concerns raised about psychotropic drugs for 3-year-olds
Posted
11-1-99 East Lansing, Mich. Very young children are being diagnosed with attention-deficit hyperactivity disorder and are often treated with psychotropic medications despite a lack of information to guide such practices. The findings appeared in the October issue of Archives of Pediatric and Adolescent Medicine. Researchers at Michigan State University in East Lansing, led by Marsha D. Rappley, MD, associate professor and director of general pediatrics, reviewed medical records of 223 children in the Michigan Medicaid system who had been diagnosed with ADHD at or before the age of 3. The study found that 57 percent of the children were given psychotropic medications-drugs that alter the brain process, usually stimulants-and that more than one-third took two or more psychotropic drugs simultaneously. "The array of psychotropic medications and the highly variable way in which they are used suggest a lack of guidance for treatment of very young children with these medications," the study says. Dolores Jones, EdD, PNP, RN, director of education for the National Association of Pediatric Nurse Associates and Practitioners, said the study shows there has not been enough research into the diagnosis and treatment of ADHD. "It looks like it's just a potpourri of trial and error," she said. Only 27 percent of the children involved in the study received psychological treatment, possibly because of limited access to mental health services-a fact disconcerting to Jones. "One of the big components in the treatment of ADHD is behavioral therapy, and medications are not as effective without therapy," she said. Nurses, particularly nurse practitioners, can be instrumental in coordinating such services for children and can work with school districts to ensure that ADHD children have access to Head Start and other early childhood intervention programs, Jones said. In addition, researchers found that 40 percent of the children were treated for physical injuries during the 15-month study period, which highlights the need for safety education for parents of children with ADHD, Jones said.
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