Poor children more likely to be put on antipsychotic drugs
Poor children are vastly more likely to be given antipsychotic drugs than middle class children, and often for less serious conditions, according to a study conducted by researchers from Rutgers and Columbia Universities and released ahead of publication.
Researchers analyzed millions of Medicaid and private insurance claims from seven big states in 2001 and 2004, designing the sample to be representative of the overall U.S. population. They found that while 4 percent of Medicaid patients between the ages of six and 17 were being prescribed antipsychotics, fewer than 1 percent of children with private insurance were being given the drugs.
Previous research suggests that the rate of illness may be up to twice as high in children from poorer families, but even that fails to explain the fourfold difference in prescription rates seen in the current study.
The researchers speculated that doctors may be more likely to prescribe drugs to Medicaid patients because the public insurer pays significantly less for non-drug treatments such as counseling than private insurance companies. It may also be harder for poorer families to make it to regular therapy appointments.
"It's easier for patients, and it's easier for docs," said New York psychiatrist Derek H. Suite. "But the question is, 'What are you prescribing it for?' That's where it gets a little fuzzy."
The study found that children on Medicaid were significantly more likely to be prescribed antipsychotic drugs for "conduct disorders" such as hyperactivity, aggression or defiance than middle class children, who were more likely to be prescribed the drugs for severe mental conditions.
Antipsychotics are approved only for conditions such as schizophrenia, bipolar disorder and autism, but the law allows doctors to prescribe as they see fit. Because the drugs have a sedating effect, they are becoming more and more popular as treatments for attention deficit disorder, even though no studies have been done on their effectiveness for that use.
Medicare spends more on antipsychotics than any other drug class, a stunning $7.9 billion per year.