TALLAHASSEE — Florida’s surgeon general is urging doctors to stop prescribing psychotropic medications to children for common mental health conditions, citing incomplete safety data and a tendency to skip non-drug options first.
In a guidance statement released July 24, the Florida Department of Health cautioned health care providers against using the drugs in patients ages 5 to 17. Surgeon General Joseph Ladapo specifically recommended against the medications for depression, anxiety, attention-deficit disorders and related behavioral conditions.
“Many psychotropic medications do not have FDA-approved labeling for children,” the guidance states. “The long-term adverse effects of psychotropic medication use in children are not well understood.”
National data cited in the document show that 14.9% of children in that age range received mental health treatment in the previous 12 months. Eight percent reported taking medication as part of that care, while 11.5% received therapy or counseling.
Department officials said children often start medication without thorough checks for environmental stressors or a trial of behavioral therapy. Research also indicates that more than half of these prescriptions come from general practitioners, nurse practitioners or physician assistants rather than specialists.
Ladapo outlined five steps providers should take before turning to medication:
- Conduct a full evaluation that includes health history, psychosocial assessment, mental status exam and observation of unstructured play, sleep and screen habits.
- Complete a physical exam with laboratory tests for nutritional deficiencies, endocrine problems, heavy metals, mold exposure and blood disorders. Additional tests such as an electrocardiogram may be warranted.
- Begin with psychotherapy, especially for milder cases.
- Train parents in evidence-based behavior management that includes regular physical activity, reduced processed foods and sugar, and sharply limited screen time.
- Consider deprescribing when appropriate, tapering medication gradually rather than stopping abruptly.
The guidance arrives months after Health and Human Services Secretary Robert F. Kennedy Jr. publicly called for greater emphasis on deprescribing psychiatric drugs.
Common childhood mental health diagnoses listed in the document include anxiety, depression, ADHD and behavioral disorders. Officials stressed that the recommendations apply except in true emergencies.
