Children in the US are more than three times as likely to be prescribed psychotropic medication as children in Germany, according to the findings of an international study.
Children and behavioral medications: a controversial topic
The data came from a study that compared the numbers of children on medication in the US, Germany and the Netherlands. It was published online in the British-based open access journal BioMed Central
It looked at data from 600,000 youngsters 19 years old and younger. It is one of the first rigorous comparisons across several countries of how medications like antidepressants, stimulants and antipsychotic drugs are dispensed among the young.
In 2000, nearly seven percent of children in the US took some kind of psychotropic medication, while two percent of German children and 2.9 percent of Dutch children did.
Criticism of Prozac, Ritalin use
Meanwhile, one in 12 of American children aged five to nine were taking these medications, four times the European levels.
The use of antidepressants and stimulants such as Prozac and Ritalin to treat hyperactivity, attention deficit and bipolar disorders in teenagers and young children has become a subject of sharp controversy.
Proponents say these powerful drugs target newly identified conditions that were undertreated or misdiagnosed in the past. But critics say the medications are being used too broadly, especially in the US. There are softer therapies that can be used to tackle behavioral problems, the critics argue.
Suspicion over direct-to-consumer marketing
Moreover, psychotropic drug use in the US may have increased since the data was collected for 2000, lead researcher Julie Zito, a University of Maryland pharmacologist, told AFP news service.
European insurers are more reluctant to pay
"The US trends appear to be continuing," she told AFP.
The study did not draw any firm conclusions about the disparity of drug prescriptions across the Atlantic. But it did note that direct-to-consumer drug advertising was allowed in the US while it is banned in Europe.
Cultural differences could also play a role, they suggest.
"The increased use of medication in the US reflects the individualist and activist therapeutic mentality of US medical culture," Zito told AFP.
There are also differences in the way behavioral disorders are defined and classified. The diagnosis of "hyperkinetic disorder" in the European medical system is more stringent than that of the "attention deficit hyperactivity disorder" (ADHD), the equivalent syndrome in the US classification.
Another difference is the fact that there are more psychiatrists per capita in the US, which could influence prescription patterns. Reimbursement policies and government regulatory constraints may also be factors.
Government health plans in Europe have also cut down on the use of expensive, patent-protected drugs, especially antipsychotics and antidepressants.