A recent study conducted by Daniel J. Safer of the Department of Psychiatry and Behavioral Sciences at the Hopkins School of Medicine explored the differences in adverse effects of psychotropic medications in children, adolescents and adults. Results showed that children experienced greater side effects to these treatments in comparison to older individuals.
People of all ages can be affected by psychiatric disorders, such as attention-deficit/hyperactivity disorder (ADHD) and depression. Regardless of the age group, affected individuals are often prescribed the same medications. Due to the limited number of clinical drug trials performed in youth, there hasn't been much emphasis in the comparison between children's responses to these medications and those of adults.
"I was inspired to write the review on age-grouped differences in side effects from psychiatric medication because: a) industry-sponsored studies minimize side effects, [which] need to be reported in depth b) psychiatric drugs may well have long term side effects that are as yet unknown. This is a particular concern with children whose development may be adversely altered c) a moderate amount of data on age differences in drug-induced side effects are available on FDA approve labels—which can be read on the internet. These findings are not commonly noted in the psychiatric literature," wrote Safer in an e-mail to The News-Letter.
Safer compiled published studies, clinical trials, case reports and open drug trials on the adverse effects experienced by different age groups in response to psychotic medication. In general, children showed increased vulnerability to numerous symptoms.
Some symptoms to which children were particularly susceptible include decreased growth velocity, rashes, vomiting, dystonia, tics, affect lability, activation, metabolic blood test abnormalities, sedation, sialorrhea and electrocardiogram irregularities. Furthermore, other side effects noted are reduced appetite, abdominal pain, weight gain and hallucinations. Drugs reviewed consisted of hypnotics and sedatives, medications for ADHD, antidepressants, antipsychotic medications and anticonvulsants.
Children may express increased vulnerability to adverse drug effects from psychotic medication because they are still growing, and many of these drugs interfere with normal development. For example, there are significantly more selective synaptic strengthening and changes in neurotransmitter levels in developing children when compared to adults.
"Children have more biological vulnerabilities than older individuals, which could account for their greater general rate of side effects from psychiatric medications," wrote Safer.
This review raises awareness of children's increased susceptibility to certain drugs, thus compelling pediatricians to pay extra attention when prescribing treatments that include psychotic medications.
Safer stresses the importance of a greater focus on the impact of these treatments on children. "More studies in the future need to focus on the long term consequences of the maintained use of psychiatric drugs in children."
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