Medicating children for behaviors; underlying dangers

(This entry is #3 in a series of posts regarding medicating children for behaviors)
In my first two posts I discussed the frightening new approach for ADD/ADHD treatment which often includes an added diagnosis of "bipolar" (the former name for this was "manic-depressive"). The source of this additional diagnosis, I believe, is very predictable. Stimulant medications such as Ritalin, Concerta or Adderal are prescribed for the initial diagnosis of ADD/ADHD. When side effects of increased dosages of stimulants lead to agitated, combative or explosive behavior in the child, the new method of treatment adds antidepressant or antipsychotic medications in attempt to quell this predictable behavior and label it with a new diagnosis of "bipolar". Unfortunately, most of these medications contain a black box warning against the use in children or teenagers.

A black box warning means that medical studies indicate that the drug carries a significant risk of serious or even life-threatening side effects. Black box warnings on medications frequently prescribed for bipolar include: Desyrel (trazadone), Paxil, Prozac, Remeron, Seroquel, Tofranil (imipramine), and Zoloft. In 2006, the FDA recommended a black box warning for Ritalin due to adverse affects on the heart ; a month later the warning was removed by an FDA advisory panel.

What should this mean to the average parent struggling for answers about the treatment of their child? Education about every medication that is prescribed is necessary: What is the medication? What classification is this medication (such as stimulant, antipsychotic, antidepressant, blood pressure medication, antihistamine)? What is it being prescribed for? Are additional medications being prescribed to combat predictable side effects from others? What are the long-term benefits of the medication versus the risks?

This is a very complicated issue. Only in the past decade have I witnessed medications of this nature prescribed to our youngest school age children; 5 year-olds are receiving long acting stimulants along with the antidepressants, antipsychotics and blood pressure medications I've just named all in the same "hand full" at lunchtime! I am concerned about how their immature bodies can process this assault to their systems.

In my next post, I will try to simplify this. We will start with understanding the basics, then move into more detailed descriptions about medications--risks and benefits.