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Britain's hidden Prozac patients, aged one to 12

The pre-school pill poppers

Sarah Boseley Health Correspondent

Thursday February 24, 2000

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.



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