Monday, June 16, 2008

Britain's child victims of the chemical cosh

The number of powerful psychiatric drugs prescribed to England's children has risen by more than half in four years, government figures have revealed.

GPs in England are handing out prescriptions for anti-psychotic drugs for children as young as seven at the rate of 250 a day, according to figures obtained by The Independent on Sunday.

Latest data compiled for the NHS show that tranquillisers designed to treat serious conditions including schizophrenia in adults were prescribed to young people 57,000 times in 2003. But the total had risen to more than 90,000 by 2006 – a 59 per cent rise in three years. The figures do not include drugs dispensed in hospitals. Experts believe the increase is partly down to early detection and treatment of serious mental health problems in children, but there is also concern they are being used inappropriately to treat psychological and learning difficulties. Shortage of staff and resources are further factors.

The drugs, which are designed to treat symptoms such as visual hallucinations, hearing voices and delusional thoughts, have serious side effects including weight gain, tiredness, sexual dysfunction and lactation. The safety and effectiveness of these drugs, which were designed for adults, have not been fully tested on children.

Official guidelines say they should be used only as part of a wider treatment package, but there are concerns GPs are relying on them too heavily because other treatments are unavailable. Some GPs, however, stand accused of ignoring or being ignorant of the guidelines.

England's mental health chief, Louis Appleby, said, "We are aware that anti-psychotic drugs are sometimes used as a last resort by clinicians dealing with highly disturbed behaviours in young people, and we are now considering how to prepare clinical guidance on this area of practice."

Psychiatrists and mental health charities have warned against using anti-psychotic drugs on developing minds. Paul Corry, director of public affairs for the mental health charity Rethink, said: "It is worrying that these very powerful drugs designed for adults are being given in such high numbers to children before their brains are fully developed.

"If the increase is because previously undiagnosed teenagers are now getting treatment, then that is positive. But it is difficult to justify the widespread use of these drugs in younger children because it is actually unlikely they will have schizophrenia at such a young age."

Anti-psychotics are commonly used to treat conditions including schizophrenia, mania and delusional disorder by blocking the chemical dopamine in the brain. But they have also been widely used for their "calming" effects in other conditions, such as autism and hyperactivity.

MPs and pressure groups have already complained about the use of anti-psychotic drugs in care homes to manage people with dementia – often to treat "behaviour that is neither distressing nor threatening, such as restlessness or being vocal".

But experts have raised further concerns about their growing use on young people. A study by the University of London's School of Pharmacy last month found that the prescription of the drugs to children almost doubled between 1992 and 2005 – with the greatest increase among children aged seven to 12.

Figures provided for the IoS from the NHS Prescription Cost Analysis (PCA) system prove that the trend has continued to rise dramatically. The increase in costs can be partly explained by the move towards prescribing newer or atypical drugs, which are more expensive but generally have fewer and less severe side effects.

But mental health campaigners are outraged by the number of older, typical drugs such as chlorpromazine and haloperidol still being prescribed. There were more than 7,000 prescriptions for these two drugs, widely known as a "chemical cosh", in 2006, which means nearly 20 prescriptions every day.

According to Rethink, there is no excuse for prescribing these powerful drugs and they should have been phased out. Mr Corry said: "The use of these older drugs is just wrong. There is no excuse at all. They may be cheaper but they are associated with some of the most debilitating and stigmatising mental healthcare from the 20th century, which led to people behaving like zombies."

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