Why are MDs still prescribing off-label powerful anti-psychotics for tots?

Inexplicable. Unfathomable. It’s tempting to reach for the thesaurus to describe the umbrage deserved for the muddle-headed decision by all too many doctors in prescribing powerful anti-psychotic drugs to patients younger than two, a practice that jumped by 50 percent from 2013 to 2014. Physicians dispensed 20,000 scripts to parents so their tots could take┬áRisperdal (generically known as risperidone) and Seroquel (quetiapine), the New York Times found in its query to IMS Health, a prescription data company. The paper further found that MDs had written 83,000 prescriptions — a 23 percent increase in one year — for tots to get the antidepressant fluoxetine aka Prozac.

All these meds never have been tested on the very young, and these high-strength drugs never were intended for use on them. The experts interviewed said taking the drugs could disrupt critical development in children and they were at a loss to explain why, then, physicians prescribed them — though, perhaps, they are being administered in difficult cases in which tots suffer disorders that make them aggressive and hard to control.

Although physicians may prescribe drugs for conditions as they see fit, this so-called off-label practice is tragically misguided and familiar. Five years ago, I wrote about a Columbia University study that raised alarms about Risperdal prescriptions for preschoolers, and if you read the New York Times story from 2010, it is eerily like the paper’s most recent report. I’ve also posted about an excellent journalistic dig into Big Pharma’s zealous hyping and selling of Risperdal, in particular — the possible harms to the young and the elderly be damned.

Experience has shown that corner-cutting corporations, which keep institution’s staff sizes too low and fail to adopt proven best practices as alternatives, over prescribe and over medicate patients for “compliance,” effectively drugging nursing home residents, in particular, in a form of chemical restraint. Federal regulators have won a $2.2 billion settlement with Johnson & Johnson and its subsidiaries over its improper promotion of Risperdal for unapproved use in nursing homes, and Medicare and Medicaid officials have pledged to step up their efforts to curb the administration of anti-psychotic drugs on the aged.

But clearly the message still isn’t getting out to caregivers, physicians especially, that avarice, convenience, and a selective indifference to their needs of their most vulnerable patients, young and old, is unacceptable. Caring for the grandma or great auntie or uncle in the deep decline of dementia is as tough a role as exists — for an individual, family, or institution; it’s painful, too, to see a baby inconsolable and perhaps thrashing, hurling, and at risk of hurting itself. If Big Pharma, medical practitioners, and legislators shifted their time, money, and resources from effectively sentencing these troubled patients to a medication-induced vegetative state and instead to addressing their needs and disorders, we’d all be better off.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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