Far less is known than most
people imagine about the prescribing of medicines to children in Britain,
because many are used in what is known as an "off-label" or "outside the
licence" way. These drugs are not licensed for children because they have
only been tested on adults, and doctors who prescribe them for minors must
do so without guidance from the manufacturers on the dosage or
side-effects.
So statistics are not kept in an organised way. Only when researchers
choose to examine what is going on by asking questions of GPs or hospital
doctors does a picture emerge of the use of adult medicines like
anti-depressants.
One such small study by the drug safety research unit at Southampton
university looked at the prescription of SSRIs - the Prozac breed of
antidepressants - for children aged 12 and under in 100 general practices.
They found just 19 children on SSRIs (selective serotonin reuptake
inhibitors) - but the average age of these children was six, and they
ranged from one year-old to 12.
Of 10 children who were given Prozac tablets, three were said to be
depressed and two were diagnosed with obsessive compulsive disorder. Two
were anxious, one had febrile convulsion - a condition that affects small
children - one had a mental disorder and the condition of one was
described as unknown.
Of those given Prozac as a liquid, one was constantly soiling, one was
bereaved, one had behavioural problems and two were anxious. Among the
others was a child with endogenous depression, which conventional wisdom
says should not affect anybody under 30 to 40 years old.
We know far more about Ritalin because it is licensed for use on
children who have attention deficit disorder - hyperactivity. The vast
majority of prescriptions for Ritalin, in fact, will be for children.
And the story with Ritalin is a massive surge in use, following the
American example, once an initial reluctance to prescribe had been
overcome. About five years ago, there were only about 2,000 prescriptions
written for the drug and the manufacturers were considering withdrawing it
from the UK market. But between 1996 and 1997, the numbers rose to some
92,000.
The drug - a stimulant which helps people to focus on what they are
doing - undoubtedly benefits some children with a serious case of the
disorder. But in the UK, as in the US, there are worries that it is being
over-prescribed for any child whose behaviour is causing parents and
school serious difficulties.
