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Harvard Reviews of Health News

Kids' Prescriptions Fall, but ADHD Drugs Up

Prescriptions written for children have dropped 7% in the last decade, a new study finds. But prescriptions rose for some drugs, including those for attention disorders. Researchers looked at prescription numbers for children through age 17. The study covered the years 2002 through 2010. The types of prescriptions that fell included antibiotics. Experts have pressed for less use of antibiotics to reduce the growth of bacteria that resist these drugs. Cold and cough medicines also were prescribed less. U.S. drug regulators warned in 2008 that these drugs should not be used in young children. Prescriptions for allergy medicines also fell. Many of these medicines now can be bought over the counter. Prescriptions for drugs used to treat attention-deficit hyperactivity disorder (ADHD) jumped 46% during the study period. That's far more than the increase in ADHD diagnoses during those years. Birth control prescriptions rose 93%. Other research has not shown an increase in the number of girls using birth control. The study authors suggested that girls who use them may be taking them for a longer time. The journal Pediatrics published the study. HealthDay News and Reuters Health news service wrote about it June 18.

What Is the Doctor's Reaction?

Do you know what the most commonly prescribed prescriptions are for children?

Thanks to a study just released in the journal Pediatrics, we now know what they are. We also know how prescribing has changed during the last few years — and it's very interesting.

Researchers at the U.S. Food and Drug Administration did the study. They used some large prescription databases to find out about outpatient prescription drug use for children up to age 17. The study covered the years 2002 through 2010.

The total number of prescriptions went down 7%. During the same years, prescriptions for adults went up 22%.

Here are some other downward trends for children:

  • Antibiotics went down 14%. They still represent a quarter of all the prescriptions written for children. However, doctors do seem to be listening to the call to decrease antibiotic use.

  • Cough and cold medicines went down 42%. Again, this shows that doctors are listening. Studies have shown these drugs don't help and can be dangerous to kids.

  • Allergy medicines went down 61%. That is most likely because most of them now can be bought without a prescription, not because fewer kids are taking allergy drugs.

  • Pain medicines went down 14%.

  • Medicines for depression went down 5%. That might be because of concerns about possible worsening depression or even suicide thoughts in some children who take them.

Here are the upward trends:

  • Asthma medicines rose 14%. That's not surprising given that we are seeing more asthma.

  • Attention deficit hyperactivity disorder (ADHD) medicines rose 46%. We are seeing more cases of ADHD, but not that many. This is a large and worrisome increase.

  • Birth control drugs went up 93%, an even bigger increase. Other studies have not shown that more teens are taking them, so it's possible that girls are taking them for longer periods of time. Or they may be using them for other reasons, such as controlling acne.

The most prescribed medicine for kids ages 2 to 11 was Amoxicillin, an antibiotic. As this is the antibiotic we most commonly use for ear infections and strep throat, it's not a big surprise.

What was a bit more surprising was that the most prescribed medicine for 12- to 17-year-olds was methylphenidate. This is a stimulant medicine used for ADHD. It is sold under the brand names Ritalin, Concerta, Metadate and Methylin. The number of children diagnosed with ADHD went from 4.4 million in 2002 to 5 million in 2010. But the increase in prescriptions is much bigger. One can't help but think that we may be overprescribing these drugs. That's very worrisome, as they can have side effects and be addictive.

What Changes Can I Make Now?

Most prescription medicines are necessary and helpful. But not all of them are necessary, and all of them can have side effects.

Whenever a medicine is prescribed for your child, ask questions. Be sure that you understand:

  • Why it is being prescribed

  • Whether there are any alternative medicines or other ways of treating the problem

  • What the possible side effects are

Being an educated consumer is always important in health care. But it's particularly important when it comes to medicines, especially stimulants. These medicines can be habit-forming and possibly dangerous. Therefore, they should be prescribed only when they are truly necessary.

What Can I Expect Looking to the Future?

This study can only give us information and trends, not the reasons behind them. Understanding those reasons is our next task, and it's an important one. This tell us more about the overall health of our children. It will give us valuable information about what we are doing with children — and what we might need to change.

Author: Claire McCarthy, M.D.
Date Last Reviewed: 6/18/2012
Date Last Modified: 6/18/2012