Antipsychotics are being increasingly prescribed to children at an alarming rate, some as young as two years old. With many adverse side effects, lack of precise diagnoses and no evidence of long-term results, it is a valid question to ask why are children on antipsychotics?

In order to answer the above question, it is necessary to be informed about the subject. What exactly is an antipsychotic? They are powerful mind-altering psychiatric drugs that are usually prescribed for bipolar disorder and schizophrenia. Brand names we commonly see advertised are Risperdal, Zyprexa, Seroquel and Abilify. Recently, many antipsychotics have been approved to treat bipolar disorder and schizophrenia inchildren. In addition, these drugs are being prescribed to children at increasing rates for a host of other lesser so-called psychiatric disorders as well.

Between 2002 and 2009, children on antipsychotics increased sixty-five percent, mostly by prescriptions for teenagers. Specifically for the age group of two to five year old taking antipsychotics, the rate has doubled in recent years. Such an increase points to the concern that these drugs are being overprescribed to children with behavior problems like aggression or irritability when there is no evidence that they are safe or effective
treatment for either. These drugs are normally prescribed for severe cases so it brings into question how a two year old could possible “need” an antipsychotic. One psychiatrist even made a point that it is questionable whether a two or three year old should ever be prescribed an antipsychotic.

In looking at children on antipsychotics one must study the side effects and see if the benefits outweigh the risks. Antipsychotics cause significant weight gain.  Within the first three months of taking the drugs, children typically gain two to three inches on their waistline. By the time six months have passed, they have gained twice as much weight as they normally would. This in turn opens the door to the risk of heart disease and of course the excess weight invites diabetes as an indirect side effect.

At the extreme, the worst side effect is death. Antipsychotics are a type of drug that blocks the brain’s dopamine receptors, which basically means that it is distorting the brain’s natural chemistry. Neuroleptic Malignant Syndrome, which can cause death within twenty-four hours, is linked to antipsychotics for this reason. Forty-one cases of this condition were reported over a five year period.

In another study, forty-five children on antipsychotics died within a four year period. Antipsychotics were named as the “primary suspect” in the FDA databaseIt is shocking to learn that an eight year old boy can and did die of cardiac arrest; and the youngest death, a four year old boy was on ten other drugs. The death of one child caused by a drug is one death too many and warrants an investigation.

Drugs being linked to life-threatening side effects or even death keep increasing, but unfortunately it’s estimated that only 10% or less are actually reported. Drug companies are required to report to the FDA, but doctors and consumers are not.  As a result, the true number of drug-induced side effects for children on antipsychotics must be significantly larger.

Of further concern is the fact that psychiatrists don’t really know what antipsychotics are doing to a child’s brain, thus bringing into question the drug’s effectiveness. A child’s brain develops throughout childhood and adolescence and it is unknown how the drug affects that development or what is the effect of the drug on the brain in the long run. There are no studies to date except for reports of continuous involuntary muscle movements (tardive dyskinesia) long after drugs were discontinued. In summary of statement from a psychiatrist at a prominent medical school, psychiatrists are conducting a large experiment by putting so many children on antipsychotics.

The other factor in answering why are children on antipsychotics is how the diagnoses are reached. Psychiatric disorders are not based on scientific evidence but only on subjective opinion. That allows for plenty of ambiguity and lacks the preciseness of regular medical conditions. So much so, all psychiatrists don’t agree on the same guidelines to diagnose children.

Some say it is difficult to tell one behavioral disorder from another. It’s possible that an aggressive and irritable child could be diagnosed as bipolar and later that diagnosis could be corrected to ADHD or vice versa. Without any medical tests or scientific evidence and without general agreement among psychiatrists, a diagnosis for a psychiatric disorder leads one to minimally question psychiatry’s validity.

On the plus side, pediatric health advisers are supporting the FDA in their continued safety monitoring of antipsychotics and are calling for them to specifically address the risks of weight gain and diabetes on the labels, particularly how it affects children. However, this is not enough. Considering the risk of death and without any proof that antipsychotics work or even how they work, the question remains, why are children on antipsychotics.