Physician’s First Watch for September 14, 2006

septiembre 14, 2006

David G. Fairchild, MD, MPH, Editor-in-Chief

Children Often Treated Inappropriately with Psychotropic Drugs

First Generic Topiramate Approved

Children Often Treated Inappropriately with Psychotropic Drugs

Children with mental health and behavioral problems too often receive only psychotropic drugs despite the effectiveness and lower risk of psychosocial treatments, an American Psychological Association panel concludes.

"Current funding and administrative mechanisms often encourage the use of medication or non-evidence-based psychosocial treatments over empirically based psychosocial treatments," their report says.

In the face of a fivefold increase in the use of antipsychotics among young people over the past decade, the panel evaluated treatments for the principal mental health disorders.

In discussing ADHD, for example, the panel's report cautions that despite evidence for the efficacy of drugs in the short term, "there is growing concern that growth suppression … will reliably accompany long-term use."

For anxiety disorders, the report says cognitive-behavioral therapy is strongly favored as the first-line treatment, in part because of concerns over drug safety.

Among the panel's conclusions: "Given the potential harm of psychotropic drugs … [practitioners should be encouraged] to treat youth with drugs only when necessary and then only with the lowest dose of the fewest medications for the shortest possible time period."

APA press release (Free)

APA report (Free PDF)

Journal Watch Psychiatry summary on children's antidepressant use (One-time registration required)

First Generic Topiramate Approved

The FDA has approved the first generic version of the epilepsy drug Topamax (topiramate).

The generic version of the drug will be available in 25 mg, 100 mg, and 200 mg tablets — a 50 mg tablet was also tentatively approved.

Because the manufacturer, Mylan, was the first to file with the FDA, it will have a 180-day market exclusivity period, after which additional generic versions of the drug may be approved.

Mylan press release (Free)

Topamax prescribing information (Free PDF)