Too many psychotropics prescribed to children? Psychiatrists alert on a report

A dramatic increase in the consumption of psychotropic drugs in children and adolescents. This is the finding of the report of the High Council for the Family, Children and Age, published on March 13.

In detail, between 2014 and 2021, drug consumption among young people would have increased by 48.54% for antipsychotics, 62.58% for antidepressants, 27.7% for anticholinergics or even 155.48 % for hypnotics and sedatives. Worrying figures for the mental health of young people and their care which have been relayed in the press, including by 20 minutes.

The report, traversed by a psychoanalytical reading grid, worries about a “phenomenon of overmedication” for “thousands of children”. This “raises fears of a risk of substitution of psychotherapeutic, educational and social aids recommended as first intention, by medicinal practices”. The High Council therefore warns of the increase in “sufficient resources dedicated to local and multidisciplinary child psychiatry approaches, and to psychotherapeutic, educational and social offers intended for the child and the family they support”.

These treatments “are very rarely a first-line solution”

What do these figures reflect? The French Society of Child and Adolescent Psychiatry and Associated Disciplines (SFPEADA) got worried in a press release of these passages on psychotropic drugs “capable of causing an erroneous understanding of the situation, even of leading to very regrettable ruptures of care”. An association of patients suffering from attention deficit disorder with or without hyperactivity (ADHD), singled out in the report, was also moved from the echo it received.

“The Company has a very clear position: drug treatments are one of the therapeutic options for caring for children and adolescents”, emphasizes to 20 minutes Oliver Bonnot, member of the board of directors of the SFPEADA. These treatments “are very rarely a first-line solution” to support a young person, adds the Company in its press release: this means that other avenues are or should be explored before prescribing a drug treatment.

Some of these treatments “have demonstrated their effectiveness in a number of situations: bipolar disorders, schizophrenia, anxiety or even attention disorders”, recalls the professor of child psychiatry and adolescents at university and at Nantes University Hospital.

“More disorders lead to more treatments”

What about this increase in the prescription of psychotropic drugs pointed out in the report? “It is old, it must be analyzed in a finer way, answers the specialist. [Le taux de prescription de] some salaries was historically low. For example, for methylphenidate [la molécule présente dans la ritaline], France remains the country in the world with the lowest prescription. »

This increase in prescription “is observed in parallel with an increase in anxiety, depressive and/or eating disorders observed over the same period”, adds the SFPEADA. “It is therefore predictable that more disorders lead to more treatments, including more prescriptions for psychotropic drugs. »

The report is also alarmed by drug prescriptions that would be made outside the cases provided for in the marketing authorizations. “This argument seems surprising to me, develops Olivier Bonnot. Marketing authorizations are requested by pharmaceutical laboratories, they are extremely expensive, so laboratories will always only request them for a pediatric population which is less medicated than an adult population. » Why do doctors prescribe drugs outside this framework? “There is still academic research on these drugs. When research can show that there is efficacy, one can prescribe outside of this marketing authorization. In order to guide doctors, the SFPEADA put online in 2019 a website “to help with prescriptions which is accessible to all”, adds the professor.

For the president of the council for childhood and adolescence of the High Council, Sylviane Giampino, psychologist and psychoanalyst, the report was not intended to be dependent on medication but questions “the imbalance between the different types of aid” , she said to our colleagues from World. The High Council’s “missions are to lead public debate and provide public authorities with forward-looking and cross-cutting expertise on issues related to the family and childhood, aging, adaptation of society to aging and well-treatment, in an intergenerational approach”.

The report also notes the difficulty of access to care while “the number of children with psychological difficulties is increasing”: “the pediatric, child psychiatric and medico-social offer is in decline and no longer allows children to be accommodated within a reasonable time. and families”. An observation shared by psychiatrists. “We are basically campaigning for us to take the time to observe situations before considering drug treatment”, summarizes Olivier Bonnot.

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