Huffington Post
By Bruce E. Levine
May 20, 2010

Children covered by Medicaid are far more likely to be prescribed antipsychotic drugs than children covered by private insurance, and Medicaid-covered kids have a higher likelihood of being prescribed antipsychotics even if they have no psychotic symptoms. This is reported in the May19, 2010 Journal of American Medical Association (JAMA) article, “Studies Shed Light on Risks and Trends in Pediatric Antipsychotic Prescribing.”

Researchers at Rutgers University and Columbia University found that children and adolescents covered by Medicaid were four times as likely as those with private insurance to receive an antipsychotic in 2004. Among those aged six to 17 years who were covered by Medicaid, 4.2 percent were prescribed at least one antipsychotic drug. In contrast, among those in this same age group who had private insurance, less than 1 percent were prescribed an antipsychotic. Nearly half of these Medicaid-covered pediatric patients receiving antipsychotic drugs had nonpsychotic diagnoses of attention deficit hyperactivity disorder (ADHD) or some other disruptive behavior disorder. In contrast, of the privately insured pediatric patients receiving antipsychotics, about one fourth were diagnosed with ADHD or some other disruptive behavior disorder.

The current issue of JAMA also reports another troubling study published earlier this year in the journal Pediatrics. This study, conducted by Robert Penfold of the Department of Population Medicine at Harvard Medical School and the Harvard Pilgrim Health Care Institute, examined the use of the antipsychotic Geodon (ziprasidone) in pediatric patients covered by Medicaid in Michigan in 2001. Of the pediatric patients who had been diagnosed with a psychiatric disorder and had received Geodon, only 53.3 percent actually had a diagnosis of psychosis. The other children who received Geodon had one or more of the following diagnoses: 24.1 percent were diagnosed with explosive personality disorder, 17.6 percent were diagnosed with depressive disorder, and 13.1 percent of these kids who were prescribed Geodon had oppositional defiant disorder (ODD). What exactly does it take to get an ODD diagnosis?

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