Antipsychotics Too Often Used to Dampen Aggression in Kids, Not Treat Psychosis

Rob Wipond
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Antipsychotics appear to be too often prescribed to curb aggressive impulses in children and youth, rather than to treat psychosis or any other clinically indicated conditions, according to research published in JAMA Psychiatry. A National Institute of Health press release about the NIH-funded study advised that antipsychotics “should be prescribed with care” because they can “adversely affect both physical and neurological function and some of their adverse effects can persist even after the medication is stopped.”

A team of researchers from Columbia and Yale universities and the National Institute of Health analyzed antipsychotic prescription data from 60% of all retail pharmacies in the United States for nearly a million patients aged 1 to 24 years in 2006 and 2010. They found that antipsychotic prescribing to young children dropped slightly over that time, while prescribing to adolescents and young adults increased.

“The percentages of young people using antipsychotics in 2006 and 2010, respectively, were 0.14% and 0.11% for younger children, 0.85% and 0.80% for older children, 1.10% and 1.19% for adolescents, and 0.69% and 0.84% for young adults,” they wrote. “In 2010, males were more likely than females to use antipsychotics, especially during childhood and adolescence: 0.16% vs 0.06% for younger children, 1.20% vs 0.44% for older children, 1.42% vs 0.95% for adolescents, and 0.88% vs 0.81% for young adults.”

The NIH press release noted that, “What’s especially important is the finding that around 1.5 percent of boys aged 10-18 are on antipsychotics, and then this rate abruptly falls by half, as adolescents become young adults.”

That fact and other patterns identified in the data, the NIH stated, suggested that the drugs were not being appropriately prescribed. “The U.S. Food and Drug Administration (FDA) has approved antipsychotics for children with certain disorders, particularly bipolar disorder, psychosis/schizophrenia, and autism. However, the research team found that the medication use patterns do not match the illness patterns. The mismatch means that many antipsychotic prescriptions for young people may be for off-label purposes, that is, for uses not approved by FDA. For example, maladaptive aggression is common in ADHD, and clinical trial data suggest that at least one antipsychotic, risperidone, when used with stimulants, can help reduce aggression in ADHD. To date, FDA has not approved the use of any antipsychotic for ADHD, making its use for this diagnosis off-label. In the current study, the combination of peak use of antipsychotics in adolescent boys and the diagnoses associated with prescriptions (often ADHD) suggest that these medications are being used to treat developmentally limited impulsivity and aggression rather than psychosis.”

Commenting in US News & World Report, the medical director of the New York State Office of Mental Health wrote, “In an accompanying editorial, Dr. Christoph Correll and colleagues stress (as he has in earlier work) the powerful and almost immediate problems (for some within 12 weeks) that antipsychotic medications can produce, especially weight gain and high glucose levels (which may predict diabetes) and abnormalities in lipid metabolism. The overreliance on medications in youth is further demonstrated by the finding that less than 25 percent of prescribed youth had any therapy services – which could include teaching parents to better manage their child’s behaviors or youth to control them. And prescribing antipsychotics seems predominantly aimed at aggressive and impulsive behaviors, especially in males, where the disruption in school and home insists on action and remediating symptoms.”

*

Olfson M, King M, Schoenbaum M. Treatment of Young People With Antipsychotic Medications in the United States. JAMA Psychiatry. Published online July 01, 2015. doi:10.1001/jamapsychiatry.2015.0500. (Full text)

NIH-funded Study is the First Look at Antipsychotic Prescriptions Patterns in the U.S. (NIH press release, July 1, 2015)

Overprescribing and Underperforming (US News & World Report, July 2, 2015)

Kids With ADHD Getting Wrong Drugs, Study Finds (NBC News, July 1, 2015)

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34 COMMENTS

  1. And when the antipsychotics are given to non ‘psychotic’ people they can, indeed, cause the person to become ‘psychotic.’ And the antipsychotics / neuroleptics are known to cause both the negative and positive symptoms of so called ‘schizophrenia.’ Via:

    “Neuroleptic induced deficit syndrome is principally characterized by the same symptoms that constitute the negative symptoms of schizophrenia—emotional blunting, apathy, hypobulia, difficulty in thinking, difficulty or total inability in concentrating, attention deficits, and desocialization. This can easily lead to misdiagnosis and mistreatment. Instead of decreasing the antipsychotic, the doctor may increase their dose to try to “improve” what he perceives to be negative symptoms of schizophrenia, rather than antipsychotic side effects.”

    And:

    “neuroleptics … may result in … the anticholinergic intoxication syndrome … Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures.”

    I believe the last one is also known as anticholinergic toxidrome:

    “The symptoms of an anticholinergic toxidrome include blurred vision, coma, decreased bowel sounds, delirium, dry skin, fever, flushing, hallucinations, ileus, memory loss, mydriasis (dilated pupils), myoclonus, psychosis, seizures, and urinary retention. Complications include hypertension, hyperthermia, and tachycardia. Substances that may cause this toxidrome include the four “anti”s of antihistamines, antipsychotics, antidepressants, and antiparkinsonian drugs[3] as well as atropine, benztropine, datura, and scopolamine.

    “Due to the characteristic appearance and behavior of patients with this toxidrome, they are colloquially described as ‘Blind as a bat, mad as a hatter, red as a beet, hot as Hades, dry as a bone, the bowel and bladder lose their tone, and the heart runs alone.'[3]”

    This might point out why so many who had adverse effects of antidepressants misdiagnosed as bipolar are doing so poorly. The antidepressants and antipsychotics should not be used concurrently. It’d be nice if the psychiatric industry woke up to this reality.

  2. The misleading thing in this article is that antipsychotics do not “treat psychosis.”

    Psychosis is most often the following – a complete failure of personality development in which severe neglect, abuse, trauma, and other stresses cause a vulnerable person to freeze developmentally at the emotional age of a very young child. Then, when pressure to function independently and form adult relationships becomes too much, the person becomes overwhelmed by the stress and starts to use psychotic defense mechanisms to survive, including withdrawal (“negative symptoms”) and primitive projection of rage/fear onto others (“positive symptoms”, like delusions and hallucinations). The use of these defenses result in the pseudo-diagnosis of schizophrenia or psychosis.

    This clinical picture in all its variations cannot possibly be treated by a pill. Overwhelming emotional distress and severely stunted personality development can only be “treated” through human relationships and love, not through zombification (i.e. tranquilizing medication).

    An irony is that zombifyers are probably much better at controlling aggression/impulsivity – i.e. dulling down a person’s overwhelming emotions so they are less likely to act out their impulses – than they are at modifying in any way the primitive defenses and emotional developmental arrest that represents psychosis.

    • dear bpdtransformation,

      As usual, your comments are well stated and highly appropriate. I believe that there are psychotic conditions that are not necessarily due to trauma, but most of what is called “psychotic” is related to the traumas that you described. I don’t tend to call individuals who experience breaks in society’s view of reality secondary to abuse and trauma “psychotic”, as I think that there is nothing out of touch with reality about how they have come to see the world or their inner lives. In fact, they are mostly giving a view of their reality that is emotionally accurate.
      The prescribing of anti-psychotics for anyone who is showing behaviour that someone doesn’t like, or who is expressing how their inner reality feels based on what their real life experience has been, should be prohibited. Psychiatrists should be in the business of healing people and not controlling people.
      I particularly like your comment that trauma can only be healed through human relationships and love. In treating people who have been traumatized, love always becomes a crucial issue, even though the psychiatric and psychotherapy professions hate the use of the “L” word. When trying to help someone who hasn’t been loved and who feels unlovable, the issue of whether that person can be or is loved is always present and has to be addressed. When a therapist tries their best to be there for someone, truly cares about who the person is, wants to wade through all the muck with them, bears witness and tries to hold or sooth some of the pain, and does this over periods of years, then one can say that real love is present. People in therapy do feel and respond to this, though often both the therapist and the patient are frightned to name it.

      • Norman,

        Thank you; I also like your comments. It is absolutely correct that most “psychotic” experience is a perfectly logical reaction to overwhelming stress, invalidation, neglect, and trauma. So, most psychosis is really not crazy. It is only some psychiatrists (and many other people) that cannot accept this, since to do so interrupts the distorted “illness/schizophrenia” narrative and threatens the ability to profit from medicalizing emotional distress via zombification (i.e. my word for excessive medication use).

        The best psychotherapists of “schizophrenia” in my opinion emphasize the need for regression to an early phase of parent-child-like relatedness that is called “therapeutic symbiosis.” This is a temporary regression to a way of relating that is common between healthy young children and loving parents. In this phase the therapist plays the role of the loving mother and the client the dependent child. Harold Searles wrote about this in Schizophrenia and Related Subjects, Bryce Boyer discussed it in The Regressed Patient and more recently Ira Steinman discussed this type of relationship in Treating the Untreatable.

        There are certain therapists who try to treat psychotic clients but want to block their desire to regress into a parent-child relationship, like Otto Kernberg and James Masterson, but that is why I think their relationships with very regressed patients were much less transformative.

        The writers on therapeutic symbiosis emphasize a point I think is important especially in America: that for very distressed people who have become psychotic, love and dependence are primary needs and usually need to be met first before the person can become independent and well-functioning. I think that in America, generalizing, we tend to overfocus on autonomy and independence and to think that needs for vulnerability, closeness and love are secondary, but that is not at all the case even in a mature person.

        So it’s sad how the need for love and the necessity of a years-long close relationships to work through trauma/psychosis, as you said, sometimes gets lost beneath these superficial useless debates about the relative value of medication vs. short-term therapy. With these articles you’d barely know there were real people underneath the labels presented.

        Thanks again for your comments; I wish more psychiatrists worked like you

      • Norman, I do appreciate what you say about love as healing because I do believe all healing happens through the heart.

        However, what you describe makes me think of the fact that 1) the clinician is getting paid, and 2) if a clinician is aware that a person is suffering from lack of love and sets out to become the one person that makes this person feel loved, then doesn’t that open the door for all sorts of transference and dependence? This seems like a power-imbalance to me that could easily lead to repetition of feeling powerless, a common early childhood trauma brought on by conditional love (which of course is not real love, more like control and manipulation).

        To me, this is one of the conundrums of psychotherapy. Where are the boundaries? Often, they often seem rather blurred and inconsistent.

        I do appreciate what you put forth, and consider it good food for thought, regarding how real and true healing occurs.

        • Alex,
          I agree with this idea of the financial aspect of the relationship and the power imbalance possibly being a block. That’s why I think “free” love and help like 12-step and/or family and friends are in some way better and more “true” than therapy.

          In my own therapy I had to force myself to put the money aspect of the relationship out of my mind. If one is too aware of that aspect of it it can lead to envy and envy can destroy the capacity for taking in love and feeling truly dependant on someone else. To feel loved one has to have the conviction that the therapist cares about you as more than just a person who pays to do therapy.

          On the other hand, a positive (idealizing) transference and infantile dependence can actually be very therapeutic for the client, even if they are at first unrealistic and not appropriate to the real person who the therapist is.

          • What makes it conditional is that without the payment, there would be no service aka no ‘love.’ So we’re dealing with some kind of illusion, here.

            Psychotherapy is a professional service, not parent replacement. That is what I feel crosses boundaries, the general philosophy and education of this. That’s my personal perspective and feeling about it. I’m aware I go against the clinical psychology grain on this one, but it’s my belief at this time. It was my graduate school education and internship training in counseling psychology that drove me to this belief, and away from the field, to other ways of practicing the healing arts.

            I think the boundary issue is what is truly problematic. Were I to hear of someone who’s been successful in setting boundaries with a mental health clinician, staff, or worker of any kind, and have it be respected without attitude or consequence, then perhaps this would give me pause to reconsider my perception of this.

            But from what I know, boundaries tend to be one-sided in a psychotherapeutic relationship, and in the mental health arena altogether. To me, that’s where the main problem comes in. It can be very disempowering for a client, and far too often, I feel this is the case.

            I’m talking in general, of course, if someone feels helped by psychotherapy, that’s great of course, no argument about that. Still, overall, I feel that these one-sided boundaries present issues which can subtly and insidiously impact a client, without hardly noticing that they really have no power in this relationship, even though a therapist would say differently. In practice, however, I feel this is the case more often than not.

    • bpdtransformation,

      I agree with everything you say, as far as it goes, but believe that there is more to it. Invariably, it is interpersonal or environmental stress or trauma that triggers (not necessarily causes) a crisis, but not in everyone. People with difficult childhoods have done very well (think Elon Musk), and people from good and loving families have broken down. If interpersonal trauma alone led to mental illness, wouldn’t just about every Holocaust survivor be psychotic? Wouldn’t every combat soldier, instead of 15% or so, suffer from PTSD? The issue centers on what makes a person “vulnerable” or predisposed to a breakdown. So, yes, I am convinced that biology, nature, the baggage that we come into the world with, matters a lot and taking it off the table, instead of adopting a holistic understanding and approach to treating mental illness undermines the movement (reforming psychiatry) and, most important, the healing of people. The overselling of talk therapy, with its underwhelming results, while failing to take seriously biological and environmental factors such as nutrients, gut health and the ever-present toxins in our environment, does not do much for the credibility of the movement and may propel some people toward psych drugs.

      • People are different and have different experiences. Have you considered that maybe these people who “break down” more easily have had more extensive experience of trauma and/or other stresses? It’s a difference when something bad happens to a person who has had a good childhood and has a supportive circle of friends and family and another matter if it happens to someone who has already had traumatic experiences in the past or feels isolated from otehr people, lonely etc. Personality of course plays a role and that is partly genetic but I believe that environmental stressors, especially the ones of social kind are more important.

        Plus how would you “fix” biology? We have all seen the disastrous effects of this approach. Are you assuming that some types of personalities are defective and have to be changed because they’re more sensitive to injustices and crimes of our world? These tend to be the very people who have the most to give to the society, not the psychopaths who rarely if ever suffer from any psychological distress. Madness is an expression of humanity, not a defect.

        • “Have you considered that maybe these people who “break down” more easily have had more extensive experience of trauma and/or other stresses?”

          Of course I have, and I don’t discount that this happens. But the opposite happens as well; people with good lives and families have succumbed to mental illness. My argument is against reductionism of any stripe or either of the extremes of the nature/nurture debate. I find epigenetics to be the most convincing explanation of mental illness, and epigenetics is ultimately about trauma and other environmental insults changing one’s gene expression. But these changes survive cell division and are transmitted to future generations, making those who inherit such changes more vulnerable to new environmental insults. Not defective, just more vulnerable or susceptible. When I say that biology matters, I mean that things like nutrients, good gut health, good diet, absence of toxins, pesticides, EMF and dirty electricity matter. Some people have been healed by orthomolecular (nutrient) therapy and amazing things are done with the microbiome. That is the type of “biological” intervention that I support.

          • Define “good life” or “good family”. The idea that you can judge if someone has a good life from the outside is simply ridiculous. It’s equivalent of telling someone to stop whining since children in Africa are starving and one has “1st world problems”.

            You never know the intricacies of one’s life. Even if everything looks fine on the outside you may not appreciate that there may have been traumatizing events in one’s childhood or permanent feeling of loneliness even if the theoretical social environment looks “normal”. On the other hand people living in terrible conditions may find themselves surrounded by others who have similar problems and therefore create a more understanding and supportive society.

      • I believe there is more to it but in a different way. Biology and environment do not work separately or in quantifiable distinct ways. They constantly interact in an ungoing unpredictable way. In fact, one’s biology is really just part of the environment, your part of the environment. Did you ever consider that? So genes are not really distinct from the environment; they are a part of the environment that is inextricably intertwined with it. Genes, or the self-planning part of the environment, are constantly being modified by the “other” main part of the environment, the external influencing side. There’s a good book about this called The Mirage of a Space Between Nature and Nurture.

        Also this 15% way of thinking about PTSD is misleading in my opinion. PTSD is not a valid diagnosis (i.e. it has no reliable biomarkers and observers often disagree on who has “it”) . Trauma/distress occurs along a continuum and it makes no sense to say that 15% of soldiers have PTSD and 85% don’t. Rather, soldiers are more or less distressed relative to themselves and others at different points in the past and future…. here is no stable PTSD illness that some people have and others don’t.

        I reject the idea of underwhelming results for talk therapy as simplistic. Talk therapy can be awesome and it can also suck and of course a continuum in between. But I think in the hands of good practitioners, talk therapy – i.e. a loving human relationship – can often be quite effective, as a number of metaanalyses show. It makes no sense to make generalizations about talk therapy. Talk therapy is not a pill like Prozac. The context and the people involved are what matter.

        I do not know enough about nutrients and toxins to comment on that. But it makes sense to me that they can be important since they are what build or harm our bodies. I would guess that how we eat can be much more helpful to emotional distress than zombification (i.e. taking neuroleptics… it occurs to me that turning into a zombie is normally not a good thing 🙂 )

        Thank you for your comments. I enjoy these debates even when we disagree.

        • “Biology and environment do not work separately or in quantifiable distinct ways. ” I agree and never said or suggested otherwise. The interaction of environment and biology — indeed, the fusing of the two down the road — is the essence of epigenetics but epigenetics impacts biology. Trauma (and other environmental insults) change one’s gene expression; when these changes are transmitted to future generations, they becomes inborn.

          The drugging paradigm, which I totally reject, asks: “what’s wrong with you; what label can we pin on you, so that we can subdue the symptoms that we do not like?”

          The questions should be: (1) what happened to you, and (2) what caused you to be overwhelmed by what which happened to you. These are 2 distinct questions. It is not invariably one’s life experience alone; it could be, but often is not. Trauma and stress is all around us; it is an inevitable part of life, unfortunately. Some people can take a lot of body blow and keep standing, others succumb with much less provocation. We should want to know why. There is far too much evidence that physical causes impair mental functioning. Why not acknowledge this and work toward a holistic paradigm of healing that takes nothing off the table? Increasing healing options is the right thing to do for the people affected, and it is the smart thing to do. More of our society might accept our view of drugging if they know about good alternatives such as nutrient therapy. The physical actually goes beyond one’s genes. The bacteria in our gut is not us genetically (they will be around even after we die, working to decompose our bodies) but they have a lot to do with our mental health. But our genes may play a role; for example, by producing enzymes that impair the gut bacteria, or by preventing the absorption of certain nutrients. So, I am all for more research into the biological causes, with a caveat that, given the perverse motivations and incentives of Big Pharma, we must be vigilant and for misuse and corruption of research (to make more drugs). It should go without saying that none of this should detract from the psychosocial or human causes, which are so much more difficult to address. How do you change society to make people more connected? I wish I knew the answer. I believe Open Dialogue is a great start but I am leery of overselling it, expecting more from it than it can deliver, thereby emboldening the druggers.

          On the efficacy of talk therapy, we will just have to agree to disagree. I know it has helped some people and I would never dissuade anyone from it. But the record is not great and overselling it does not help the cause of psychiatric reform; just the opposite. There are conditions for which talk therapy is inappropriate (e.g., retained infant reflexes, certain types of early trauma). Don’t you think it is somewhat probative that so many psychoanalysts rely on drugs even as they tout their therapeutic prowess?

          • A lot of interesting ideas here. Although I’m not knowledgeable about it, I think your points about nutrients are probably right on. I do acknowledge you! 🙂 Certainly good nutrition should be more helpful for most people than turning them into the zombies from 28 Days Later (i.e. giving them psych meds).

            I like to think of what you call biological “causes” as elements in the complex system of interpenetrating factors inside and outside a person. Factors like poor nutrition may or may not cause or be the tipping point that moves a person into a more distressed state. But yes they can be factors so they should be addressed holistically as you say. I think good diet and exercise are so important and taken together are way more helpful for people than (long-term) zombification.

            Regarding psychotherapy’s efficacy when delivered long-term, I have some data for you:

            http://psychrights.org/research/Digest/Effective/BGSchizophreniaMeta-Analysis.htm

            http://www.centerforselfdevelopment.com/pdf/000004-effectiveness-of-long-term-psychodynamic-therapy.pdf

            I think it’s hard to argue that most people who engage in a long-term positive relationship with a therapist aren’t going to be significantly better off, as these articles evidence. Not everyone will be helped, but many will.

            I am not aware of (most?) psychoanalysts relying on drugs as they tout their therapeutic prowess. Do you have a source for that?

    • Hi Alex,

      Your points are well taken and important. Boundaries and power issues are always present in therapy, and especially with people who are most traumatized in life, the boundaries are always blurred. This is a difficulty. One has to work with and address the real relationship while being aware of transference issues. It is never easy, either for the individual in therapy or the therapist. While therapy does involve a financial agreement, it can also be a caring relationship. One has to recognize that there are power imbalances and aspect of personal gain in so many relationships. Certainly for those who come from traumatic backgrounds there has almost always been huge power imbalances with parental figures often acting for their own emotional benefit with a lack of empathy for the child. These issues will get activated in any therapy. However, in a good therapy, despite the financial consideration, the person in therapy will experience the therapist as being more truly concerned with the persons welfare than with their own needs. There are usually significant aspects of teaching, mentorship and other parental types of interactions in therapies with traumatized individuals. A therapy is not a replacement for parenting, but it can be transformative.

      • Well taken, Norman. Personally, I prefer to work with clients who do take responsibility for themselves, otherwise they get stuck in blame, victim, and co-dependence, and I see no going forward, keeps everyone stuck. Guess I’m no hero to anyone, but then again, I’d prefer to not be as that would be self-delusional; but rather I’d prefer to be someone doing their job as per agreement, keeping boundaries nice and clean.

        I do not assume a client cannot take care of him- or herself. I’m just an adjunct to their process, committed to helping them find and identify with their naturally validating spirit voice over their self-punishing voices. To me, that’s always the issue. They have to take it from there. That way, we don’t get enmeshed, and the client feels self-empowered rather than ‘taken care of.’

        Again, my own personal path as healer, I feel it’s sound, and it’s what I really craved when I was in therapy years ago, a counselor who didn’t try to take over my life as though they were my guardian or something, it was so inappropriate and self-inflating to them. I got tired of clinicians telling me that they are taking vacation and they understand that I’ll be angry because I’ll feel abandoned. ???? Um, I’m not 5 years old.

        So that’s the kind of stuff I’m thinking about when I talk about this. I ran into a lot of presumptuous clinicians that, because I had some intense issues with my dad, they thought they would be my surrogate dad (at age 45), which was quite demeaning, considering I’d been out in the world my entire adult life, taking good care of myself, working, etc. I felt they were stuck in their own need to parent someone, which was not my issue, but theirs. Can’t heal with those kinds of projections being cast, it’s impossible.

        Not at all saying this is you, Norman, but it’s what discussions like these bring up for me. You seem truly like a very loving and kind person, which I totally value and appreciate. The world can’t have enough of that right now.

        • Not to belabor this, but I’ve continued to think about this–such a great topic for this field, and the world in general, I think it’s vital to relationships–and just want to add one more thing, for clarity–

          I’m not suggesting cold and impersonal, rigid boundaries to self-protect. I do feel healthy boundaries are flexible, and appropriate to the moment, still being consistent as far as communicating them goes, and how we set up expectations, taking responsibility for how and what we communicate to others.

          This is always an area for awareness growth and refinement, this is not a very clearly-boundaried society, so to speak, lots of weird manipulation happens as a result. That’s been my pretty consistent observation in my 54 years of living. I’ve certainly taken those lessons, myself.

          I’m really talking here about emotional boundaries. It’s the attachments that concern me, that I feel that psychotherapists often foster for their own needs. I think it’s unconscious, but common, and terribly counterproductive and undermining to healing, if we are talking about personal freedom. If not, then I’m not sure what we’re talking about. Anything less is compromise.

          • I think that people need real relationships not fake ones bought by money. Psychotherapy is to this like prostitution is to love. It can maybe help some people to go on in the short time but what most people need is a real friend.

          • I had always seen psychotherapy as a professional service to help people figure out why they are repeating self-sabotaging patterns. That takes a certain neutral, non-judgmental presence to listen to a person’s story and find the highlights which lead to where something got stuck and was left unresolved, causing these undesirable blind spots. This might take a few sessions, or perhaps for particularly intense and repeated trauma, maybe 6 months to a year. Then, a person can move on.

            That would be a valuable professional service from which a lot of people could benefit at no risk, if the focus and boundaries were to remain clear.

            However, it’s since turned into “let me be your best friend, the one who listens to you and gets you, since everyone around you sucks.” For a fee.

            That’s the opposite of ‘professional;’ that is personal enmeshment, which is what muddles everything up, because the therapist’s ego issues can easily be more present than the client’s, while the client remains unaware and appeased.

            When psychotherapists become surrogate friends, parents, siblings, or ‘gurus’ and expect money in return, then the relationship takes a turn away from anything of healing value.

  3. This is nothing new. I encountered it decades ago. If one had watched the TV show ER there was an episode on this type of drug with an adolescent in a group home being drugged with haldol – gut wrenching.
    There is no safe place for many folks or kids who are suffering emotional distress and or trauma in our society. There are some faith based homes like Catholic Worker or L’Arche but small in number and they have had some issues.
    Sometimes there are hurts that can only take years to resolve. No ones fault. It is what it is.
    Under stress folks can act in ways that they would if they could choose not to.
    It is up to the helping professions to own up to the problems and rise above the ways they have handled emotional distress in our country.

  4. “And prescribing antipsychotics seems predominantly aimed at aggressive and impulsive behaviors, especially in males, where the disruption in school and home insists on action and remediating symptoms.”

    This is where psychotic delusions and rationalizations are going unaddressed in people who think this way. In reality, they are HURTING THE CHILD, to control behavior. When they call it “remediating symptoms”, it doesn’t change that fact. I’m sure history will eventually look back on it for what it was, and wonder why an entire generation of people allowed children’s brains and bodies to be injured — even permanently so — to break temper tantrums and deal with bad behaviors that have always occurred in children throughout time. While I’m no advocate for corporal punishment, just imagine if spankings caused tardive dyskinesia. Today, it’s illegal to so much as leave a little red mark on a child during a spanking, because supposedly THAT is wrong. But permanently damaging their brains, giving them life-long neurological symptoms that make their own body a 24/7 demon they must endure with involuntary motor movements, FOR THE REST OF THEIR LIFE… that’s just a consequence of “remediating symptoms”, a “side effect” of “treatment.”

    • “remediating symptoms”
      These are not symptoms. An they are not treating someone’s illness they’re getting rid of inconvenience for them on the expense of the poor kid. I hate this perverse, sick language so much. Orwell would be proud to have come up with that one.

  5. A boy aged 10 in Western Australia, Perth just held up a truck driver, with a cap gun. Recently he has been up to other mischeif. The report quoted his mother and brothers in the court, being quite distraught, ie not your average disfunctional, non caring family.
    Sounds so much like antidepressants/antipsychotics being prescribed to a young one, and he is suffering. Anyway, I forwarded this article, and an explanation to the author of the artcle :

    Ref: The Sunday Times, Western Australia

  6. I think there is an important underlying issue that is not being discussed in this thread, specifically the under-resourcing of child protective services and the foster care system in many if not most states which leads to a high proportion of the use of these drugs.

    In well-intentioned but ultimately profoundly damaging efforts to “preserve the family”, kids who have been removed from their birth home are repeatedly removed to foster care, returned to their birth family, and pulled back out again. The process adds tremendously to the psychological damage caused by the original abuse, and by the time many of these kids are permanently removed from the home, they are horrifically traumatized.

    The problem is further complicated by a profound shortage of people willing to serve as foster parents. At one point the Michigan state legislature actually debated a law to require welfare recipients to serve as foster parents as a condition of aid. What a mess!

    The upshot of all this is that terrible psychological damage is done to kids in the system, they end up tremendously difficult to care for, and the resources and support provided by the state for doing so are minimal. We knew people whose foster kids wiped feces on the wall, assaulted their foster parents, and in one case burned down the home they were living in. This is a lot to ask of foster parents, who are recieving a monthly state stipend of about $200 per kid.

    It is a terrible thing to drug kids, and a very easy thing to criticize. But the volunteers taking care of these kids are doing the best they can, and need to be safe. If you want to do something about this terrible problem, one has to go deeper than simply trying to outlaw the use of drugs. The entire system needs to be revamped to move children out of abusive homes and into stable environments before they become traumatized, and in some cases, violent. There needs to be more resources (other than 15 minutes with a shrink every two weeks) made available to help these kids with their transition, and their needs to be more people volunteering to care for them.

    • “law to require welfare recipients to serve as foster parents as a condition of aid”
      SERIOUSLY?

      “monthly state stipend of about $200 per kid”
      How much is the monthly dose of anti-psychotic? We can’t give money to kids but we sure as hell can spend it to enrich drug companies.

      “If you want to do something about this terrible problem, one has to go deeper than simply trying to outlaw the use of drugs.”
      No. You start with outlawing what is obviously wrong. Then people will be forced to find otehr solutions and then you can work on the right as opposed to bad ones. Otherwise there’s no reason for the system to change. It’s like saying: you can’t simply outlaw slavery, you have to go deeper and address social issues in black communities. Sure one has to but the injustice has to be fixed first.

      “other than 15 minutes with a shrink every two weeks”
      Having known some shrinks in my life I would not let any of them near my cat, let alone a traumatized child.

      • Well, no, I’m not saying there is nothing you can do but wait till the entire system is revamped. For one, you could volunteer. The ones with a history of violence are particularly difficult to place. If you want to to that, and feel you can do it without drugs, that’s a wonderful thing. On the other hand, if you just want to criticize people who are doing far than you are, that’s less than ideal.

  7. I’d actually like to offer that to all the folks on this thread. Before criticizing people who welcome deeply troubled children into their homes, risking assault, fire, the torture and killing of pets, and sometimes the sexual abuse of their biological children, try volunteering and doing what they do. Show you can do it better. Otherwise you’re just an obese and out of shape fan sitting in the stands, throwing empty beer cans at real athletes because they don’t meet up to your arbitrary standards of athletic performance. Its not very attractive behavior.

    • I have people in family who run a foster home. They do not drug the kids and have not experienced any of what you have described even if the kids are sometimes very troubled. Kids who enjoy killing animals etc. are usually beyond reach and will grow into psychopaths but they are a small minority of otherwise normal little humans. And even the budding psychopath does not deserve being forced on these drugs. If the kid is doing all of the above mentioned things and no humanly done intervention can help – there is juvenile justice system. Assault and sexual molestation land you in a detention centre.

  8. John Smith, your anger is not very attractive either.Foster care has long history with ongoing problematic issues. Many of these echo those of adoptive parents. Trauma does devastating things things to adults much less children. They have no words so they act out or re enact their own trauma. Many Foster Parents and Adoptive Parents are truly not given fully informed consent and others are just bad news. Luck plays a huge role in all of this.Every now and then the idea of orphanages comes up. They had their strengths but also many,many weaknesses.
    The first case of child abuse documented in this country had to use an act for abused animals.
    That says it all. It’s not that we don’t know its that we don’t want to pay.
    Many kids in the system love their parents in some way shape or form. Many are able to recognize when things are getting bad. Again like adults in crisis there is no safe haven less now then ever before.
    What we as a country or the world need to do is set up safety nets where kids and folks can go to during times of crisis. You live your same life but have four safe walls. This would be with no time limits or constraints. Medicaid does not like this!
    This gives kids and folks in crisis agency. Treatment professionals need to trained in trauma and have the chance to look into their own lives. They need to be not only aware of but have a deep knowledge base of alternative therapies.
    I have come to believe that one can heal but it takes time and many many times of trying different things. Many times this takes money.
    The trauma of having a foster child in crisis without any true support is awful for the kid and the family. Same with those folks in adoptive families. Trauma comes in every shape and size and I don’t thin we will ever know how it will all play out. Our only hope is witnessing and having healing options for all.
    To my dying day I will never forget how I referred an adolescent to a so called “”good child care agency” with a supposed ” wonderful” leader. Months later I read how the “leader ” ( it was before the time of social service agencies administrators bowing down to corporate America and labeling themselves CEO’s and COO’s.)v was found to be sexually offending his adolescent clients. My kids fit the prototype to a tee. Stupid me. This was the kids I tried to hard not to be drugged.
    I have other traumas. from my time as a Social Worker. Sometimes I think a lot of the helping professionals numb out or choose to numb out by many methods. That is why I get angry when professionals refuse to actually dialogue and really respond from the heart with psych survivors and those who have been in the child welfare system. The only hope I had back then was that some of the kids would talk. And some are.Lots of pain all around and only by dealing with it can we truly find a solution!

    .