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Should Children Be On These Medications?

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CHILDREN MEDICATIONS

Millions of kids today are on meds for conduct disorders, depression, bipolar disorder, oppositional defiant disorder, mood disorders, obsessive-compulsive disorders, mixed manias, social phobia and of course ADHD .

But according to new data from IMS health in a Wall Street Journal article, just as many kids are being treated for non-psychiatric conditions that are often "adult diseases."

Since 2001, high blood pressure meds for kids have risen 17 percent, respiratory meds 42 percent, diabetes meds 150 percent and heartburn/GERD meds 147 percent. Fifty percent of pediatricians also prescribe kids insomnia drugs according to an article in the journal Pediatrics.

In fact, 25 percent of children and 30 percent of adolescents now take at least one prescription for a chronic condition says Medco, the nation's largest pharmacy benefit manager, making the kid prescription market four times as strong as the adult in 2009.

Why? Well one reason is the pediatric population is suffering from "middle age spread" just like the adult population from too many calories and too little exercise. Over a third of U.S. kids are overweight and 17 percent are obese -- which for a 4-foot-10 inch child would be 143 pounds. Obesity predisposes children to diabetes, hypertension, high cholesterol, sleep apnea, gallbladder disease, osteoarthritis and musculoskeletal disorders.

But another reason is the direct-to-consumer drug advertising on TV which began over a decade ago. In between ads for M&Ms, Reese's Peanut Butter Cups, Oreos, Hershey's Milk Chocolate and Doritos, kids and their parents saw $108 million worth of ads for Prilosec, $100 million for Claritins and $91 million for Zocor in 2000 -- when the national "epidemics" of GERD, "seasonal allergies" and "statin deficiencies" began.

Consider statins like Lipitor, the world's top selling medication, which was approved for U.S. children in 2008 and recently in a chewable form in Europe. In addition to known risks of liver dysfunction, acute kidney failure, cataracts and muscle damage, they can enable bad eating. 2010 article in the British Medical Journal.

"Plenty of adults down statins regularly and shine off healthy eating because they know a cheeseburger and steak can't fool a statin," writes Dr. Michael J. Breus on the Huffington Post. "Imagine a 10-year-old who loves his fast food and who knows he can get away with it if he pops his pills."

And asthma/allergy drugs? Long-acting beta-agonists or LABAs found in Serevent, Foradil, Advair and Symbicort sometimes worsen asthma, causing asthma-related intubation and death. (Right, exactly what they were supposed to prevent! ) And who is at the highest risk for harm and death from the drugs? Children 4 to 11 years old!

And then there's GERD in babies.

Even though the approximately 71 times a day that babies spit-up is considered perfectly normal and does not damage the esophagus, the number of GERD prescriptions for babies has recently quadrupled writes pediatrician Darshak Sanghavi. The drugs don't treat baby reflux but they "may increase brain bleeds and gut damage in preterm infants as well as the risk of food allergies in older infants," says Dr. Sanghavi, author of the bestselling book "A Map of the Child" Oops.

Since the pricey "Purple Pill" heartburn drug Prilosec debuted over a decade ago, followed by Nexium, proton pump inhibitor drugs (PPIs) that switch off stomach acid producing cells, have become veritable "purple crack" say U.S. doctors.

And even though heartburn is not a valid indicator of GERD -- it can exist without esophageal damage and vice verse -- and PPIs are often prescribed for intestinal tract pain where no hydrochloric acid even exists, half of all hospital inpatients are now put on PPIs writes Dr. Sanghavi. (The head of Medicaid and Medicare admonished AMA doctors in 2003 "You should be embarrassed if you prescribe Nexium, because it increases costs with no medical benefits.")

Known to increase the risk of bone fractures in women and cause heartburn and reflux when patients try to quit, PPIs can cause headache, abdominal pain, nausea, constipation, diarrhea and increased risk of community-acquired pneumonia in children say medical sources.

Why are so many meds targeted to the child patient?

"Children are known to be compliant patients and that makes them a highly desirable market for drugs," says former pharma rep Gwen Olsen author of "Confessions of an Rx Drug Pusher." "Children are forced by school personnel to take their drugs, they are forced by their parents to take their drugs, and they are forced by their doctors to take their drugs. So, children are the ideal patient-type because they represent refilled prescription compliance and 'longevity.' In other words, they will be lifelong patients and repeat customers for Pharma."

There is also "clinical laziness," says Dr. Sanghavi. "Nexium is over-prescribed for the most banal of reasons: It's less work to write a prescription and pretend the problem is solved."

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