Pros and Cons of Giving Adult Drugs to Children

By NEIL GENZLINGER
Published: January 8, 2008
The attention-deficit generation has been supplanted by the bipolar generation, we learn in Tuesday night’s “Frontline” on PBS. And overmedication of children is not the only concern these days. Parents may now be turning their youngsters into guinea pigs.
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Frontline
The Koontz family on “The Medicated Child.” DJ, 4, in front, takes medicine for bipolar disorder.
The report, “The Medicated Child,” revisits territory “Frontline” first examined in 2001, raising some familiar warning flags and some new ones. But it’s not a knee-jerk treatment. As the program points out, there are pros as well as cons to the increased use of prescription drugs on children.
The trendy diagnosis of the moment for children, we’re told, is bipolar disorder, that drastic series of shifts in mood and energy once thought to be an adults-only problem. And rather than giving troubled children relatively familiar antidepressants, there is a corresponding move toward treating them with less predictable, less thoroughly studied antipsychotic drugs.
“We’ve taken a drug that has very limited risk and replaced these drugs, often with a class of drugs that have unknown efficacy but quite well-known risks,” says Thomas R. Insel, director of the National Institute of Mental Health. “And I’m not sure that that’s progress.”
Medical professionals talk forthrightly about the guesswork involved in treating children who exhibit bipolar behavior: the constant switching of medications and tweaking of dosages. And, as the program notes, if a problem emerges with a drug, even the seemingly obvious step of issuing a government warning is perilous. The warning might leave children who really need that particular medication less likely to get it; the pendulum swings from risky overuse to dangerous underuse.
The obligatory children flit through the program, possibly to detrimental effect. We mostly see well-behaved youngsters doing what children do; in other words, the “after” picture. Anyone who has not experienced a truly troubled child “before” — before the parents sought the help that medications can bring — may think the parents of the ones seen here guilty of needlessly drugging their youngsters. But as with most aspects of this issue, things are rarely that simple.
FRONTLINE
The Medicated Child
On most PBS stations on Tuesday night (check local listings).
Marcela Gaviria, writer and producer; Will Cohen, co-producer. A Frontline production with RAINMedia Inc. Frontline is produced by WGBH Boston.