State health officials are moving to more closely monitor children who have no diagnosis of bipolar disorder, schizophrenia or other psychosis but have been prescribed "off-label" use of psychotropic drugs. State officials said out-of-date technology issues make it difficult to tell whether patients have a diagnosis.
Officials plan to require prior approval for so-called off-label prescriptions "in the very near future."
"This is a high-priority item, but it is too early in the process to state with certainty when this will be resolved," Medicaid department spokesman Marc Williams said.
Psychotropic drugs include antidepressants, mood stabilizers, stimulants and anti-anxiety medications. Antipsychotics are the most powerful of these drugs, with brand names such as Abilify, Zyprexa and Risperdal. Researchers found half of the children on antipsychotics were prescribed the medication for "off-label" reasons.
The move to require prior approval for off-label use, approvals for use of the drugs for children under 5, and identifying doctors prescribing dosages above approved levels, are part of recommendations from a panel of psychiatrists, social workers and child welfare experts formed by Colorado last year.
Some psychiatrists and other supporters of the medications said children are more likely to have severe mental illnesses that require medication and benefit from a new generation of antipsychotics.
"One big reason is the trauma that these kids have had in their lives," said Dr. Judy Zerzan, chief medical officer of the Colorado Department of Health Care Policy and Financing. "Their lives have not been easy — that's why they are in the foster-care system."
Critics counter that the use of the drugs has been fueled by pharmaceutical firms pursuing big profits with the help of willing doctors and that few studies have examined side effects on children. Critics say the drugs have been linked to weight gain, diabetes and growth of breasts in boys, as well as leaving them as if they were "in a cloud."
"The less a child has a powerful, invested adult advocate, the higher the probability that people will just use interventions that are meant to marginalize or basically zombie-fy kids," said Dr. Bruce Perry, a doctor at Houston-based ChildTrauma Academy who is a national leader in pushing for less medication and more therapy to treat the root causes of children's mental problems. "They are just sedating them and trying to control their behavior. Kids just sort of stumble through whole stages of their lives.
