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Study finds 'frightening' over prescription in drugs to fight depression -

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TANYA NOLAN: Health researchers say they're worried by a sharp increase in the frequency with which anti-psychotic drugs are being given to children and adolescents.

A landmark study by the University of Sydney has found the rise in the number of prescriptions for medications to treat attention deficit disorder, severe depression and psychosis is as much as 50 per cent.

Simon Santow reports.

SIMON SANTOW: Ritalin has a reputation as the drug of choice to treat a condition known as ADHD, or attention deficit hyperactivity disorder.

The Sydney University study found that over a four year period, ending in 2012, the use of Ritalin jumped by 35 per cent nationwide.

EMILY KARANGES: They are frightening figures.

SIMON SANTOW: Lead author Emily Karanges is from the university's School of Psychology.

EMILY KARANGES: These trends are showing that we are increasingly willing to treat more mild cases and sometimes we're even treating cases that are not diagnosed mental illnesses.

And I think this is problematic and seeing rapid increases in this suggests that we are neglecting other forms of therapy.

SIMON SANTOW: She says doctors in Australia were already relatively heavy prescribers of this sort of medication and that was before the recent jump in activity.

EMILY KARANGES: I think we can't lose sight of the fact that a lot of kids are helped by these drugs and we definitely can't demonise them. I suppose we're concerned that these increases suggest that we're seeing increased drug usage in more mild cases and that drugs have become a first line treatment option.

SIMON SANTOW: Anti-depressant medication for children aged between 10 and 14 jumped by more than a third.

Anti-psychotic prescriptions rose by almost 50 per cent.

EMILY KARANGES: Anti-depressant prescription and anti-psychotic prescription are increasing more rapidly in children and adolescents than they are in the adult age group. So we're seeing increases of up to a third in anti-depressants.

SIMON SANTOW: While the rate of prescription for children and adolescents is still nothing like it is for adults, the study's authors say they are worried that other treatments aren't being favoured by medical practitioners.

Emily Karanges from Sydney University.

EMILY KARANGES: So we know that anti-depressants are more like to have side-effects in children, side-effects like paradoxical increase in suicidal thoughts, self-harming behaviours. Children with a risk of bipolar disorder, it can actually precipitate that and with the anti-psychotics, we know that in adults and children they can lead to obesity, diabetes, they can sedate quite a lot and these effects are greater in children.

SIMON SANTOW: The researchers say they want a more cautious approach to prescribing these drugs to children.

Professor Philip Mitchell is the head of psychiatry at the University of New South Wales and a professorial fellow at the Black Dog Institute.

PHILIP MITCHELL: I think we need to be a little bit more sophisticated about this. All of us would be reluctant to unnecessarily prescribe to children and adolescents. We're aware that often there are important psychological issues that need to be addressed.

For some young people, particularly adolescents, conditions like depression are real issues. Sometimes this doesn't respond well to psychological treatments and can do well with medication.

So I'd be saying that while caution is clearly critical, that there's an important role, even though it's I think a relatively small role, for careful prescribing, particularly of anti-depressants but also for young kids with ADHD, that that often doesn't do well with psychological approaches.

SIMON SANTOW: Put simply, say in the case of anti-psychotic medication, what can be the difference between prescribing a patient and leaving a patient to other methods of treatment?

PHILIP MITCHELL: Anti-psychotics are used for conditions like schizophrenia and bipolar disorder. These conditions can present during adolescents. I think that's normally in later adolescence rather than early in adolescence and very rarely during childhood.

So for the young child with his clear cut schizophrenia, or clear cut bipolar, and I emphasis these are relatively uncommon in young adolescents, but these can be very effective medications.

Again, we've got to be careful we don't overprescribe but for children with clear psychotic illnesses such as those, these can make a huge difference to people's lives.

TANYA NOLAN: Professor Phillip Mitchell is the head of psychiatry at University of New South Wales speaking there with Simon Santow.