NEW YORK (Reuters Health) – The number of drugs dispensed to U.S. minors has dropped slightly over the past decade, bucking the rise in prescriptions to adults, according to a government report released Monday.
Antibiotic use fell by 14%, suggesting efforts to curb rampant overuse of the drugs “may be working,” researchers from the U.S. Food and Drug Administration (FDA) wrote in Pediatrics.
But the new report also found an uptick in the use of some drugs in children, with stimulants for attention deficit hyperactivity disorder (ADHD) leading the pack.
From 2002 to 2010, the use of ADHD drugs grew by 46% — or some 800,000 prescriptions a year. The top drug dispensed to adolescents was methylphenidate (Ritalin), with more than four million prescriptions filled in 2010.
“What the article is suggesting is that the number of children that we are treating for attention deficit disorder has gone up,” said Dr. Scott Benson, a child and adolescent psychiatrist and a spokesperson for the American Psychiatric Association.
“For the most part I think the overall increase reflects a reduction in the stigma,” he told Reuters Health. “It used to be, ‘You’re a bad parent if you can’t get your child to behave, and you’re a doubly bad parent if you put them on medicine.’”
Dr. Lawrence Diller, a behavioral pediatrician who has written extensively about ADHD, was more critical of the rise in stimulant prescriptions, noting that the U.S. is far ahead of other countries in its use of the drugs.
“You have to look at how our society handles school children’s problems. It’s clear that we rely much, much more on a pharmacological answer than other societies do,” Dr. Diller said. “The medicine is overprescribed primarily, but under-prescribed for certain inner-city groups of children.”
A report in the New York Times last Sunday said stimulant abuse is rising even among healthy high schoolers, who are easily fooling their doctors into prescribing the drugs.
“There is no objective test, so obtaining the medications is relatively easy,” said Dr. Diller.
The new findings are based on data from healthcare research firm IMS Health and do not include drugs given at hospitals.
Overall, there were 263 million filled prescriptions to minors in 2010, down 7% since 2002. After taking population changes into account, that corresponds to a 9% drop; by contrast, adult prescriptions rose by 11%.
Prescription drugs classes that showed marked dips among children included allergy medicines, cough and cold drugs, painkillers, and antidepressants.
Apart from ADHD drugs, asthma medicine and birth control pills also showed increases.
The FDA said it could not explain the reasons behind the changes.
ACID REFLUX IN INFANTS
The agency also looked at lansoprazole (Prevacid) due to concerns about efficacy and safety in infants. The medication is not indicated for children younger than one, and studies show it has no effect in that age group. Yet doctors wrote 358,000 prescriptions for the drug to babies under one in 2010.
Dr. Eric Hassall, a pediatric gastroenterologist at the California Pacific Medical Center, said the number reflects rampant overuse of acid drugs in infants.
“These drugs work very well when they are prescribed for the right indication,” he told Reuters Health. “But in infants they are very seldom indicated.”
He added that stomach acid is the first defense against many infections and blocking it even for part of the day will raise children’s risk of pneumonia and stomach infections.
“My concern is that we are unnecessarily exposing infants to infectious and nutritional complications,” Dr. Hassall said. “Doctors are too quick to prescribe and parents are very quick to demand, and this is of course driven by consumer advertising.”