Name Removed
ENGL 101, Sect. 0202
Prof. Thomas Geary
August 15th, 2009
The Silent Murder of Our Children
Every day, hundreds of thousands of children in the United Sates are being
poisoned. This is happening right under our noses, and the people who giving them
poison are the same people who are supposed to be giving them support and care. By
prescribing antipsychotic medication to children, doctors are unnecessarily putting our
children at risk for serious harm and even death. The use of antipsychotic medication in
children is unethical due to their harmful physical, social, and cognitive side effects and
the lack of studies investigating their long-term effects.
Antipsychotic medications were designed to alleviate psychotic symptoms, such
as thought delusions and auditory and visual hallucinations. These symptoms are most
commonly characteristic of Schizophrenia, a debilitating mental illness, but can also
appear in Bipolar Disorder (American Psychiatric Association 2000). The Food and Drug
Administration (FDA) has approved these drugs for the treatment of Schizophrenia and,
more recently, Bipolar Disorder in adults, but not for children (U.S. Department of
Health and Human Services 2008). Despite this, the incidence of antipsychotic drug
prescription for children with Schizophrenia, Bipolar Disorder, and Attention Deficit
Hyperactivity Disorder (ADHD) has skyrocketed in the last decade. In fact, recent studies
have reported a 6-fold increase of their prescription in the last decade (Olfson et al.
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2006)). If this trend continues, we will have a whole generation of unnecessarily
medicated children, and I fear for their well-being.
Consider the case of Eric, whose name has been changed for the purpose of
confidentiality. Eric was a healthy three-year-old boy living a normal life until his mother
found him with a bottle of his brother’s Abilify, an antipsychotic drug (Schonberger,
Douglas, and Baum 2004). Upon closer inspection of the contents of the bottle, Eric’s
mother realized that he had eaten half of a pill. Two days later, Eric developed a severe
tremor, began shaking uncontrollably, and his movements became grossly uncoordinated.
He was rushed to the hospital and underwent a week of intensive treatment; luckily, his
symptoms resolved.
While I understand that this was an extreme case and that the boy was younger
than most children who are prescribed these medications, it does highlight one of the
major concerns associated with antipsychotic medications: extrapyramidal symptoms.
Extrapyrimidal symptoms are symptoms that are caused by antipsychotic medications
and involve a disturbance of facial and body movements (Gale Encyclopedia 2008). They
consist of Akathesia (a sense of inner restlessness that results in an inability to remain
motionless), Dystonia (sustained muscle contractions that cause twisting, repetitive
movements, and abnormal postures), and Tardive Dyskinesia (uncontrollable facial
muscle contractions, specifically in the tongue). In other words, antipsychotic drugs are
associated with a debilitating loss of motor control, and there have been many studies that
have demonstrated this association (Leucht et al 2009). The implications of these
symptoms in children are almost too tragic to visualize, but that is the harsh reality of
these medications. A child who experiences these side effects would most likely not be
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able to participate in many physical activities, would likely be ostracized by his peers,
and would have a difficult time learning in a normal classroom setting.
Next, consider the case of John, whose name has also been changed for the
purposes of confidentiality. John had been diagnosed with Attention
Deficit/Hyperactivity Disorder (ADHD) as a young child (Logue et al. 2007). ADHD is a
developmental disorder characterized by attention problems and hyperactivity
(Biederman 2008). While this disorder is traditionally treated with stimulants such as
Adderoll and Ritalin, antipsychotic medications have been used to treat particularly
severe cases (Findling and McNamara 2004). At the age of seven, John was put on
Abilify, a newer, “safer” type of antipsychotic. Within four weeks, he was taken to the
emergency room. John had developed hyperglycemia, a condition of having toxically
high levels of sugar in the blood (Princeton 2009). John was discharged after three days
but had to undergo four weeks of insulin therapy to get his blood sugar levels down to
normal. Seven months later, he was diagnosed with Diabetes Mellitus, an incurable
disease in which the body cannot transport sugar from the blood to its cells for energy
(American Diabetes Association).
Unlike the case of Eric, John’s case is far too common. Numerous studies have
shown that children who use antipsychotic medications are more likely to develop
Diabetes Mellitus (Tobin 2006, Logue et al. 2007, Leucht et al. 2009). While advances in
medicine and medical technology have helped make Diabetes more manageable, it does
not usually appear at such a young age, and the health implications are not fully
understood. Moreover, a recent study by the World Health Organization ranks Diabetes
Mellitus as the eighth leading cause of death in high-income countries (2008).
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As if these weren’t enough, many studies have demonstrated that antipsychotic
medications also cause significant weight gain in the majority of people who use them
(Feforowicz and Fambonne 2005). Drs. Fedorowicz and Fambonne conducted a study in
which they examined the results of 40 studies that recorded the side effects of
antipsychotic drugs. The combined studies involved over 500 patients and almost all of
them reported significant weight gain as a result of the medications (2005). Obesity has
been associated with many negative health conditions, such as stroke, cancer, and
cardiovascular disease, the number one cause of death world-wide (Khan et al. 2009,
World Health Organization 2008).
In addition to the physical health risks, childhood obesity has significant negative
social implications. In one study that looked at 416 high school students found that obese
adolescents were more likely to be physically and verbally victimized by their peers,
were less likely to date, and were more likely to be unsatisfied with their dating lives than
their normal weighted peers (Pearce, Boergers, and Prinstein 2002). Another study that
looked at over 9,000 7th, 9th, and 11th grade boys and girls found that obese adolescents
were more likely to experience severe emotional problems feelings of hopelessness, and
were more likely to have attempted suicide (Falkner et al. 2001). Feelings of
hopelessness and suicide attempts are two of the main symptoms of clinical depression,
and the addition of this illness to an already mentally compromised child would be too
much for most people to handle (American Psychiatric Association 2000). Finally, Drs.
Datar, Sturm, and Magnabosco performed a study where they measured the math and
reading scores of 11,192 kindergartners and found that overweight kids performed
significantly worse than their non-overweight peers (2004). At an age where friendships
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are built and important academic and social skills are learned, the significant weight gain
associated with antipsychotic medications would significantly disrupt normal
development and put the child at a disadvantage for the rest of his or her life.
Given all of the dangers associated with antipsychotic medications, there has to be
some reason why they are prescribed to children in such increasingly large numbers;
there have to be people who feel that they provide some benefit that outweighs all of
these costs. These proponents claim that the medications help ease the main symptoms of
Schizophrenia, Bipolar Disorder, and ADHD, and there has been some evidence that the
medications do provide some benefit to that effect. One study on the effects of
Rispiridone, an antipsychotic, in 79 children aged five to 12 showed that Rispiridone
decreased irritability, anxiety, hyperactivity, conduct problems, and over sensitivity (Shea
et al. 2005). Another study by Dr. McCevoy and colleagues at the Duke University
Medical Center looked at psychotic symptoms in 400 schizophrenia patients that were
divided into three groups, each receiving a different antipsychotic medication (2007).
They found that all three groups experienced reductions in hallucinations, delusions,
blunted affect (lack of emotions), and anhedonia (an inability to feel pleasure). There is
no doubt that the improvements in these symptoms experienced by the patients in these
studies provided immense relief, but the majority of them also experienced weight gain,
increased blood pressure, and insomnia. These symptoms were manageable throughout
the course of the studies, but it is not known if this would have been the case if the
studies lasted for a few years, and that is one of the most important flaws in the
arguments of those saying that antipsychotic medications are safe to use in children:
There have been no studies investigating the long term effects of using antipsychotic
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medications in children and adolescents. There have not even been many studies
investigating their short-term effects. While a couple have shown promising results, there
has not nearly been enough to say that they are safe.
What about cognitive functioning and academic performance? Could it be argued
that these medications might be worth their side effects because they improve cognitive
ability? In 2006 a study was performed at the National Institute of Mental Health in
which the cognitive ability of healthy volunteers was compared to that of medicated and
unmedicated patients with Bipolar Disorder (Pavaluri et al. 2006). The results showed
that both medicated and unmedicated patients performed worse than healthy controls on
all measures; the medication had no effect.
There are benefits to taking antipsychotic medications. For children who have
severe debilitating Schizophrenia, these drugs could help them regain their sense of
reality and function on a more normal level. For the less severe forms of this illness, and
for children with Bipolar Disorder and ADHD, antipsychotic medications are not the
answer. To put any child at risk for the life threatening physical and social side effects
that are associated with these medications is unethical, but to risk these in a child who is
already hindered by a judgment-impairing mental illness is criminal. Pharmaceutical
companies are currently lobbying for the FDA to approve their drugs for use in children
(Dooren 2009). Unless we lobby for the other side and make our voices heard, it will only
be a matter of time before they gain their approval and more of our children are
unnecessarily exposed to this poison.
Works Cited
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Audience Analysis
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The primary audience for this paper is made of parents who do not work in the medical
field. The majority of them do not have personal experience with kids who have mental
illnesses and need some kind of treatment, but they are all aware of the debate over
whether or America is overmedicating its children. Many of the people who are in favor
of the use of antipsychotic medication and pychotropic medication in general are either
doctors, family members of doctors, friends of doctors, or people who have had personal
experiences with mental illnesses (either in themselves or in friends or loved ones), this
audience is primarily against using antipsychotic medication to treat children. Since they
are not in the medical field, the words in this essay must be understandable to the general
public while at the same time convincing them of the credibility of the author. Since this
topic is one that is very controversial with passionate arguers on both sides, appeals to
pathos must be made in addition to logos. This essay was designed to take advantage of
the strong emotions that the American public feel towards their children and uses words
like “poison” and “tragic” to get them to be emotionally involved in the cause. This essay
could appear in the New York Times Editorial Section, as it uses academic research to
appeal to a more popular audience. The secondary audience would be doctors and
academics who read these types of articles. They would have a much greater knowledge
of the medications and illnesses talked about, and would likely have experience in
treating children with them. They would be much more critical of the arguments made in
the essay, and would respond more to appeals to logos. The overhearer is Professor
Geary. He is looking at the essay from a different perspective than both the primary and
secondary audiences. While they are primarily interested in the message and arguments
in the essay, Professor Geary is more interested in the arrangement, style, presentation,
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diction, sources, and overall structure of the essay. The author of this is the parent of a
mentally healthy child who is very against antipsychotic medication.
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