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Medicating mentally ill children: what parents need to know

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SALT LAKE CITY — Utah parents increasingly have to make difficult decisions when it comes to medicating their children. In fact, kids as young as 2 years old are beginning to exhibit signs of mental illness.

Many children are treated with atypical anti-psychotics — drugs prescribed for schizophrenia and bipolar disorder. But you need to do more than just read the warning label before making the decision to medicate your child.

Problems spiked for one Salt Lake boy as he started junior high.

"He would have angry outbursts in which he looked like a feral animal," his mother said. "He threw a chair through the living room window."

But doctors see cases of children much younger. Another mother writes of her daughter: "From the time she was 2 she had told me, 'I can't control my body. My body is out of control.'"

It wasn't a case of bad parenting, or bad kids. In both cases the culprit was bipolar disorder.

"It seems there is a progression of this as it marches down the age route, in that younger children are having more symptoms and signs," said Dr. P. Brent Petersen, the clinical and medical director of the Pingree Center.

Petersen says there's no easy answer to why younger children are developing serious mental illnesses like bipolar disorder and schizophrenia.

The illnesses can be treated with atypical anti-psychotics. And while the FDA has only approved those drugs for adults 18 years old and up, doctors can prescribe them "off label" to children — a decision Dr. Kristi Kleinschmit of the University of Utah Neuropsychiatric Institute does not make lightly.

"There is really a dearth, or absence, of a lot of studies of our medications that we use in kids," she said.

Both doctors stress the importance an accurate diagnosis. Since this class of drugs is known to cause weight gain, the risk of developing diabetes goes up. There are also neurological side effects, including a movement disorder known as tardive dyskinesia, and possible heart risks as well.

"There are doctors who in their busy practice tend to forget all of the elements to warn parents of the possibilities because they're so rare," Petersen said.

"If we can be more specific in our diagnoses, we will be less likely to put kids on medicines for a really long time that they may not need," Kleinschmit said.

But the right diagnosis with the right prescription can be life changing. One mom who made the decision to medicate a year ago says her young daughter has gained weight but "the difference is amazing, and others have commented how much more self-assured and confident she is."

As for the other family who worked to getting the dosing right: "We will always live with uncertainty and fear, but we also have a level of acceptance and hope, and these are good things."

Another reason to get the proper diagnosis: Doctors have seen some kids medicated unnecessarily, and that seems to happen at a higher rate with low-income families.

A Rutgers University study found that low-income kids were four times as likely to receive anti-psychotics as privately insured families.

e-mail: sdallof@desnews.com