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Date: 08:10 PM CDT on Thursday,
October 19, 2006
Resource: Daily Herald
Study warns of Ritalin's effects on
preschoolers
CHICAGO – Is it safe to give
preschoolers Ritalin, the popular attention deficit disorder drug?
The first long-term government study of that age group warns of side
effects with the stimulant drug, which isn't recommended for
children under age 6.
There were benefits for children who had severe ADHD, but the
researchers said preschoolers on Ritalin need close monitoring
because they're more likely than older children to develop side
effects.
The research was done because of concerns over reports that soaring
numbers of preschoolers are being given psychiatric drugs, including
Ritalin.
The study's message is, proceed with caution, said Dr. Thomas Insel,
director of the National Institute of Mental Health.
"We're not talking about fidgety 3-year-olds," said Insel, whose
agency funded the study.
The research involved children with severe attention deficit
hyperactivity disorder with behaviors that included hanging from
ceiling fans, jumping off slides or playing with fire. The
researchers say the benefits of low-dose treatment outweigh the
risks for these youngsters.
But critics disputed that.
"I hope publication of this does not lead to more overprescribing,"
said Dr. Sidney Wolfe of the watchdog group Public Citizen. "The
safety isn't adequately established, the efficacy even less."
About 40 percent of children developed side effects and roughly 11
percent dropped out because of problems including irritability,
weight loss, insomnia and slowed growth.
Preschoolers on methylphenidate, or generic Ritalin, grew about half
an inch less and gained about 2 pounds less than expected during the
70-week study.
"This is a catastrophe. It just opens up the way for drugging the
younger kids," said Dr. Peter Breggin, a New York psychiatrist and
longtime critic of psychiatric drug use in children.
Breggin said the research is part of a marketing push by the drug
industry to expand drug use to the youngest children.
The study appears in the November edition of the Journal of the
American Academy of Child and Adolescent Psychiatry. Several of the
researchers have financial ties to makers of ADHD drugs, including
Ritalin.
Lead author Dr. Laurence Greenhill, a psychiatrist with Columbia
University and New York State Psychiatric Institute, has been a paid
speaker for most companies that make the drugs.
Roughly 8 percent of U.S. children have ADHD, including around 3
percent of preschoolers.
Previous research found that about 1 in 100 preschoolers had been
prescribed Ritalin, which has only been approved for use in children
aged 6 and older. Use in younger children is considered "off-label"
but is not illegal.
Dr. David Fassler, a psychiatry professor at the University of
Vermont, said the study does a good job of outlining pros and cons
of Ritalin treatment in preschoolers.
"This is exactly the kind of information we need to help parents
make informed decisions about treatment options for young children
with ADHD," Fassler said.
The study included 10 weeks of behavioral treatment along with
parent training and about one year of drug treatment. Nearly 300
families were enrolled, but many dropped out after the first phase,
either because the behavior treatment worked or because they didn't
want to put their children on drugs.
The drug phase started with 165 children, more than a dozen dropped
out because of side effects.
Behavior improvements were seen in children taking 7.5 to 30
milligrams daily, but the optimal dose was 14 milligrams daily –
less than half the usual Ritalin dose for older children, Greenhill
said.
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