The new Prozac and ... Nation

It seems Mother's Little Helpers aren't just for mother anymore.

They're for little Johnny, Tommy, Ricky and Nancy too. Oh, and maybe Georgie. He's only 3 years old but showing signs of depression and hyperactivity as well.

The FDA's approval of the anti-depressant Prozac (or fluoxetine hydrochloride) in 1987 opened a momentous door for the psychiatric community. Until then, psychiatric drugs held numerous side effects and, perhaps, even greater social stigma.

The extensive marketing of Prozac and the subsequent marketing of drugs like it (Paxil, Zoloft, etc.) lead to the effective prescription of the drug to millions of individuals around the world. No longer was it said in hushed tones that "so and so was on anti-depressants." Many believe that the drug's wide use and marketing has made it one of the most successful in American pharmaceutical history.

Fast forward almost 20 years.

Last year in the United States, about 1.6 million children and teenagers [HTML_REMOVED] 280,000 of them under the age of 10 [HTML_REMOVED] were given at least two psychiatric drugs in combination. More than 500,000 were prescribed at least three psychiatric drugs. And more than 160,000 received at least four medications together, according to an analysis performed by Medco Health Solutions at the request of The New York Times.

These statistics come despite the fact that in 2005, after years of speculation and warning, the FDA required drug makers to label their drugs with the warning that antidepressants can cause suicidal thoughts and behavior in some children. More and more children, however, are prescribed these drugs often in combination with others each year.

The catch is, according to numerous studies from the National Institute of Mental Health, Johns Hopkins University, American Journal of Psychiatry and opinions of countless other researchers, there is no scientific evidence to justify the multiplication of pills taken by children. Even for single drugs, there is questionable evidence in support of their effectiveness.

More recently, according to The New York Times report, "more psychiatrists have been asking whether in some cases drugs are being prescribed for children who do not need them, or for problems that fall within the spectrum of normal behaviors."

First we were "The Prozac Nation," now we're "The Prozac and ... Nation."

Now, I'm no Tom Cruise. There is no doubt that there are children that are need of therapy in combination with psychopharmacology, just as there are adults whose lives are changed for the better due to the introduction of mood-stabilizing drugs.

One wonders, however, in an age where the speedy medication of adults is frequent, how many children are medicated to excess simply for being themselves.

That rowdy kid on the playground, the energetic terror running around the house all day and breaking things [HTML_REMOVED] he must be a perfect candidate for an anti-psychotic and an anticonvulsant, maybe even a sleep aid too.

The shy child who prefers to play by herself and lashes out at children who come near [HTML_REMOVED] she must be a perfect candidate for an anti-depressant.

Both children's personalities would have seemed slightly abnormal 30 years ago, but merely a part of phase [HTML_REMOVED] something an individual would outgrow.

Perhaps as our children grow up faster, we expect them to snap out of behavioral phases faster, too. If they don't, well, just like antibiotics for a sinus infection there's an easy cure.

Unfortunately, for the children the cure is anything but easy.

Many psychiatric drugs prescribed for children have numerous side effects, such as drastic weight gain or loss, a stunt in growth or development, sluggishness and fatigue.

Prescribed anti-depressants for two years as a teenager, I found myself constantly tired and unable to register most emotions. I stopped being able to laugh or cry at movies, and then stopped being able to laugh or cry at almost everything else.

Many of my friends who were quickly prescribed anti-depressants during their adolescence testify to similar experiences.

In the end, when we decided for ourselves to stop taking the drugs, we all felt better.

Researchers are now finding that, for many individuals prescribed medication as early as 6 years old, stopping medication and letting children grow up organically may just be the key to normality.

One hopes that for the millions of children now on these medications, researchers will continue to take a closer look at their effectiveness. Because when children cease to be able to laugh or cry, no matter what their other symptoms, they aren't children anymore.

Columnist Maureen Trantham: maureentrantham@thdaily.washington.edu