Government raising caution on use of psychiatric drugs among preschoolers

From staff and wire reports

WASHINGTON (CNN) -- Hillary Rodham Clinton launched a federal program Monday to caution parents about giving preschool children Ritalin and other psychiatric drugs meant to treat attention deficit disorders.

The first lady said the effort, involving four federal agencies, is not to "bash" the use of such drugs but to provide more information to parents, school officials, social workers and health-care providers.

Citing a recent report in the Journal of the American Medical Association, Mrs. Clinton said that from 1991 to 1995, use of Ritalin among U.S. preschoolers increased 150 percent and antidepressants like Prozac went up more than 200 percent.

She emphasized the need to include family therapy and other behavior modification with drugs in treating children exhibiting disruptive emotional or mental problems.

The new federal effort includes additional warning labels for the drugs, a national study of their use and a fall conference on children's mental health.

A primary target will be removing the social stigma of children receiving treatment for emotional or mental illnesses, said Mrs. Clinton, who is a candidate for the U.S. Senate from New York and a long-time children's advocate.

Involved in the program will be the U.S. Department of Education, the National Institute of Mental Health, the U.S. Food and Drug Administration and the Office of the Surgeon General.

Ritalin is a common brand name for the stimulant methylphenidate, which is believed to increase a child's alertness by stimulating the central nervous system.

Attention deficit disorder, or ADD, usually is diagnosed in school-age children based on interviews and observed behavior.

Symptoms of ADD include the restless inability to sit still to read, study or even watch television. Often a child cannot play in group games, and a common symptom is the inability to control impulses. Some mild forms of these symptoms are common in many children, leading experts to worry that ADD is diagnosed too often.

Some authorities worry that the drugs supplant behavior therapy, which in many cases might be more helpful.

In addition to Ritalin, more young children are also taking clonidine, a blood pressure drug used to treat sleep problems stemming from attention disorders, and antidepressants such as Prozac.

The National Institute of Mental Health will begin a nationwide study of Ritalin use in children under the age of 6. Children at selected sites around the nation will be observed.

"While behavioral therapy can be very effective and medication was most effective, probably the wisest course to go for treating children is both," one federal official observed.

CNN Medical Correspondent Eileen O'Connor and The Associated Press contributed to this report.

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