Antipsychotics and the Kids

A long time ago, I posted a set of rules that I used to help me to navigate the treacherous roads of children's mental illness. (Note to new readers- I am a pediatrician, not a child psychiatrist, and am a bit humbled by the new medications now at our disposal.) One of those rules was pretty straightforward:

There is little evidence to support using two psychotropic medications to treat AD/HD in children, and none to support using three.

According to the New York Times a few weeks ago, I was pretty close to the mark. Young children have been overprescribed medications for no good reasons. Often. What was interesting to me is why this was suddenly front page news? Anyway, I was not surprised and unhappy at the line taken by the pediatrician in the story: You have to do something when people come in desperate for help. Unfortunately, the right answer, frequently, is to do hold back on the big guns, and use focus on the hard stuff, like behavior management and family supports.

Nice article, with a nice "shout out" for Mary-Margaret Gleason, a triple boarded child psychiatrist who I have not seen in too long.

I'm back to seeing patients today, screening away for mental health and behavioral health problems. So far, not much. But I've only been back for 2 weeks. More later.