The ethics and science of medicating children.
Prescriptions for psychiatric drugs to children and adolescents have skyrocketed in the past 10 years. This article presents evidence that the superior effectiveness of stimulants and antidepressants is largely a presumption based on an empirical house of cards, driven by an industry that has no conscience about the implications of its ever growing, and disturbingly younger, list of consumers. Recognizing that most mental health professionals do not have the time, and sometimes feel ill-equipped to explore the controversy regarding pharmacological treatment of children, this article discusses the four fatal flaws of drug studies to enable critical examination of research addressing the drugging of children. The four flaws are illustrated by the Emslie studies of Prozac and children, which offer not only a strident example of marketing masquerading as science, but also, given the recent FDA approval of Prozac for children, a brutal reminder of the danger inherent in not knowing how to distinguish science from science fiction. The authors argue that an ethical path requires the challenge of the automatic medical response to medicate children, with an accompanying demand for untainted science and balanced information to inform critical decisions by child caretakers.
Sparks
Jacqueline A
JA
The University of Rhode Island, Kingston, RI, USA.
Duncan
Barry L
BL
D000293:Adolescent; D000928:Antidepressive Agents / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy; D002648:Child; D002651:Child Advocacy; D002986:Clinical Trials as Topic / Q000592:standards*; D016265:Conflict of Interest / Q000191:economics; D004345:Drug Industry; D011307:Drug Prescriptions; D005473:Fluoxetine / Q000627:therapeutic use; D006801:Humans; D008389:Marketing of Health Services; D033242:Minors; D010919:Placebos; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000627:therapeutic use*; D012107:Research Design; D012109:Research Support as Topic; D013240:Stereotyping; D016896:Treatment Outcome
D000928:Antidepressive Agents; D010919:Placebos; D011619:Psychotropic Drugs; D005473:Fluoxetine