Volume 219 - Issue 6
Increased prescribing of psychotropic medication for children and adolescents during the COVID‐19 pandemic: no cause for alarm
Authors: Alain Braillon and Wendy A Rogers
Med J Aust 2023; 219 (6): 285-285. || doi: 10.5694/mja2.52071
Published online: 18 September 2023
Published online: 18 September 2023
Comment
To the Editor: We find Hazell's editorial troubling.1 In it, Hazell concludes that “rather than inappropriate, it [the increased prescription of psychotropic medications for children and adolescents during the coronavirus disease 2019 (COVID‐19) pandemic] was an example of the system working as it should”. It is unclear how the author could reach this conclusion based on the two articles2,3 cited in the editorial.
Hardie and colleagues2 report on psychotropic prescribing for children by general practitioners during the COVID‐19 pandemic. They conclude “our findings suggest that the capacity of the Australian health care system to increase mental health care provision during a time of crisis is inadequate”.2
Woods and colleagues3 also note the increased prescribing and question “the safety and benefit of psychotropic medications for children and adolescents”. For example, the prevalence and incidence of antidepressant prescribing to girls increased by 20%, despite these medications having an effect size no better than psychotherapies, plateauing at around 0.30 versus placebo, with severe withdrawal reactions and serious adverse effects, including suicidality.4
In 2012, when Allen Frances, chair of the task force that produced the Diagnostic and statistical manual of mental disorders (DSM)‐IV, predicted that the DSM‐5 “will medicalise normality and result in a glut of unnecessary and harmful drug prescription,“5 he underestimated reality. A decade later, Hazell commends increased prescribing of psychotropic medication in children and adolescents while failing to engage critically with either the implications of that increased prescribing or the role of the management of the COVID‐19 crisis in increasing mental disorders.
Errare humanum est, perseverare diabolicum (making mistakes is human nature, but persisting with the same mistakes is demonic behaviour)
Competing interests
No relevant disclosures.
References
- Hazell PL. Increased prescribing of psychotropic medication for children and adolescents during the COVID‐19 pandemic: no cause for alarm. Med J Aust 2023; 219: 16‐17. https://www.mja.com.au/journal/2023/219/1/increased‐prescribing‐psychotropic‐medication‐children‐and‐adolescents‐during
- Hardie RA, Sezgin G, Pont LG, et al. Psychotropic medication prescribing for children and adolescents by general practitioners during the COVID‐19 pandemic. Med J Aust 2023; 219: 26‐27. https://www.mja.com.au/journal/2023/219/1/psychotropic‐medication‐prescribing‐children‐and‐adolescents‐general
- Wood SJ, Ilomäki J, Gould J, et al. Dispensing of psychotropic medications to Australian children and adolescents before and during the COVID‐19 pandemic, 2013–2021: a retrospective cohort study. Med J Aust 2023; 219: 18‐25. https://www.mja.com.au/journal/2023/219/1/dispensing‐psychotropic‐medications‐australian‐children‐and‐adolescents‐and
- Hengartner MP, Plöderl M. Statistically significant antidepressant‐placebo differences on subjective symptom‐rating scales do not prove that the drugs work: effect size and method bias matter! Front Psychiatry 2018; 9: 517.
- Braillon A, Lexchin J, Blumsohn A, Hengartner MP. The “pharmaceuticalisation” of life. BMJ 2019; 365: l1972.