Child Psychiatrists Prescribing More Sleeping Pills for Children

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According to new research, insomnia in children is a widespread problem, and psychiatrists often resort to medication. This shocking finding was discovered by Dr. Judith Owens from the Brown Medical School in Providence. She and her colleagues found that in a survey of child psychiatrists, ”insomnia was a major problem in almost a third of their school-aged and adolescent patients and (they) endorsed using medication to treat the insomnia in at least a quarter of these patients.”

Owens survey nearly 1,300 members of the American Academy of Child and Adolescent Psychiatry and had them complete a survey to examine the clinical practice patterns regarding non-prescription and prescription medication for insomnia by child and adolescent psychiatrists. Based on their responses, Owens found that insomnia is a significant clinical issue among nearly one-third of the psychiatrists' school-aged and adolescent patients.

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What was more disturbing was that an overwhelming 96 percent of the clinicians recommended at least one prescription medication in a typical month and 88 percent recommended an over-the-counter medication. The sleep medications prescribed ranged from antihistamines to sedating medications for Attention Deficit-Hyperactivity Disorder (ADHD), such as alpha agonists (clonidine), to antidepressants like trazodone. They also included medications from a number of other categories, such as antidepressants, antipsychotics and anticonvulsants, depending on the psychiatric or behavioral diagnosis of the child.

“The most important rationale for the use of sleep medication among child psychiatrists is to manage the effects of sleep disruption on daytime functioning. It is important to note, however, that concerns about side effects and the lack of evidence regarding their effectiveness were cited as significant barriers to their use,” said Owens. ”Despite the high frequency of use and the wide range of medications chosen, practitioners also expressed a number of significant concerns about the appropriateness of sleep medication in general for children.”

Owens states, ”That is why child psychiatrists may be potentially more likely than pediatricians to prescribe medication for insomnia. Furthermore, use of other psychotropic medications, which can have significant negative effects on sleep in this population, frequently complicates clinical management of sleep issues in child psychiatry patients.”

Owens concludes, “Mental health professionals responsible for the care of children should set as a goal the establishment of an evidence-based understanding of appropriate treatment choices for insomnia. In addition, we need a more comprehensive understanding of insomnia in the context of psychiatric disorders in general and the impact on quality of life and long-term prognosis in these patients.”

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