Disturbing Rise in Psychiatric Medication for Infants in the US

When Andrew Rios was only a year and a half, doctors prescribed him Risperdal, a psychiatric drug used to treat schizophrenia and bipolar disorder in adults. This was due to severe, recurrent seizures that began when he was just five months old, exacerbated by a previously tried anti-epilepsy medication that incited violent behavior, causing him to push his siblings and even break toys.

At some point, after taking Risperdal, little Andrew began screaming in his sleep and talking to imaginary people and objects. This made his mother panic and investigate the medication being consumed by her son. To her astonishment, she discovered the drug was not approved for children Andrew's age and, furthermore, there were no studies proving its efficacy or, worse, the potential damage and risks associated with its use in young children.

“They told me, 'Take this, there’s no problem,' as if these pills were Tic Tacs,” Andrew’s mother, Genesis Rios, from Rancho Dominguez, California, and a mother of five, explained. “But he was just a baby.”

Andrew’s neurologist, Dr. Lily Tran from the Children’s Hospital in Orange County, prescribed the drug to moderate severe mood swings, though intended for older children. He took it for four months until his mother noticed behaviors she had never seen in him before, deciding the side effects were too severe and ceased the medication. "Everything got worse," described Rios. The neurologist declined to be interviewed for the story. Frighteningly, Andrew is just part of a much more alarming statistic.

(Photo illustration: Shutterstock)

Last year saw a chilling surge of about 50% in anti-psychotic prescriptions, a trend continuing to this day, as reported by the New York Times. Experts warn about the phenomenon, fearing the unknown damage to children, spurred by a critical shortage of child psychiatrists, broad access to prescription rights for any doctor, and the well-meaning but misinformed attempts of desperate doctors to aid parents at wit’s end.

The statistics compound the distress, revealing nearly 20,000 anti-psychotic prescriptions for drugs like Risperdal (Risperidone) and Seroquel (Quetiapine) were issued in 2014 to children under two in the US alone.

In contrast to previous years, this marks a sharp 50% increase. Comparatively, the year prior saw "only" about 13,000 such prescriptions. An increase of approximately 23% was also noted for the well-known antidepressant Prozac (Fluoxetine), with prescriptions rising to 83,000 annually, again for toddlers under two.

Continuingly, last year, the Centers for Disease Control and Prevention (CDCP) published a report indicating at least 10,000 children aged two to three were being treated with psychiatric medications like Adderall, after being diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). This defies the guidelines of the American Academy of Psychiatry .

In response, many psychiatrists and neurologists specializing in child treatment were stunned by the figures, stating their difficulty explaining the trend and noting they had never encountered cases of children under three receiving psychiatric medication. Some suggested that well-meaning doctors, upon seeing the parents' desperation, provide medications to alleviate children’s tantrums or symptoms perceived as depression. Others speculated that the prescriptions might not be intended for the children but rather the parents, registered under the child's name for insurance discounts.

Notably, neither the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, nor the American Academy of Neurology have clear guidelines or a defined position regarding the use of antidepressants and antipsychotics in children under three..

However, the FDA has a stance: it approves using these medications for children but only at much older ages. For example, Prozac is approved for treating childhood depression at age 8 and up, with obsessive-compulsive disorder approved from age 7. Similarly, medications for psychotic disorders are approved from age 10, but if related to autism, approval is granted from age 5. The intolerable leniency of any physician being able to prescribe any medication they see fit without oversight leads to the problem.

Consequently, many doctors express concern about the continuation and expansion of psychiatric medication administration to infants as young as less than two years old, for treating retreatment or violent behavior.

To date, no research has been published regarding the effects of these drugs on young children, especially concerning the risks and damage involved in long-term usage, and the absence of research in this area is no accident. According to Dr. Marie Margaret Gleason, a child psychiatrist and physician at Tulane University School of Medicine in New Orleans, the brain of children under two is developing at a rapid pace in ways that remain largely unknown. Therefore, medicating without understanding how it affects brain development entails serious risks. "There are no studies," she states, "and I’m not attempting to initiate or fund such research."

"People are doing the best they can with the tools at their disposal," Gleason adds. "Families with suffering children are desperate, and the tool most doctors have is the prescription pad."

The primary reason for this situation may be the severe shortage of psychiatrists specializing in children's care. Currently, there are only 8,350 such professionals across the US, with overwhelming demand. However, with this demand comes long waiting lists and significantly higher costs than visiting regular pediatricians, who receive minimal training in this field.

Moreover, identifying children on psychiatric medications is challenging due to privacy protection or because their prescription is controversial. A fierce debate occurs among child psychiatrists over Risperdal’s use. Some highlight positive effects, but full disclosure is critical—many receive financial support from pharmaceutical companies, while others vehemently oppose the drug’s use, claiming it’s a short-term solution for complicated issues.

However, in cases requiring cessation of repetitive seizures in very young children, some other psychiatric drugs, like anti-anxiety medications such as Valium or Rivotril and Klonopin, are widely accepted. This acceptance exists when used occasionally and despite unknown effects on the young brain. Dr. Amy Brooks-Kayal, head of pediatric neurology at the Children’s Hospital in Colorado and president of the American Epilepsy Society, supports this view.

Dr. Martin Drell, former president of the American Academy of Child and Adolescent Psychiatry, expressed his dismay at the findings, firmly opposing it and asserting, "there's no smoke without fire. We must investigate the matter to protect the children. We must identify these cases. Even if it’s not 10,000 children but just a few hundred, it would be very regrettable in my view."

There are those with alternative solutions, emphasizing not rushing to such medications at such young ages. "Behavioral methods exist to address such issues instead of drug therapy," says Dr. Ed Tronick, leading a program training emergency medical service workers to assist families with troubled children. "What causes the child’s fear, anger, or withdrawal? What causes frustration and stress in the parent? These are what need examination, though it requires time and money."

So what to do in the meantime? It seems that only boundless, genuine love, prayers, and lots of patience can solve many problems.