PEDIATRIC DRUG CONCERNS PROMPT NEW STUDY

Health: White House To Step Up Research Into Children's Use Of
Prescriptions Such As Ritalin And Prozac. Experts Agree Issue Needs Attention.

WASHINGTON--The White House said Monday that the federal government
will intensify research on medications used to treat preschoolers for
behavioral disorders, responding to growing concerns about the high
number of youngsters who take prescription drugs such as Ritalin and
Prozac.

The government said it will launch a $5-million research project over
five years to study children who take Ritalin to treat
attention-deficit disorder; redouble efforts to study labeling and
dosage of psychiatric drugs for youngsters; and convene a conference
on the issue to be held in the fall.

Monday's announcement was orchestrated by First Lady Hillary Rodham
Clinton, who is running for the U.S. Senate in New York and who has
championed children's issues during her husband's presidency.

Some details about the initiative--such as the scope and launch date
of the Ritalin studies--remained unavailable Monday. Other parts
seemed to repackage policies that are already in place.

But Clinton administration officials insisted that fresh answers are
needed on a topic that affects millions of American children and
parents. One recent study found that the usage of stimulants or
antidepressants among certain groups of children ages 2 to 4 had more
than doubled from 1991 to 1995.

"We must unlock the mysteries of children's mental health--which
treatments are the most successful, whether some children are being
systematically misdiagnosed," said Donna Shalala, secretary of Health
and Human Services.

Despite the potential political overtones, some health care experts
said the event served a useful purpose.

"I think it's significant that they're calling attention to this
problem and saying we really need to figure out what's going on," said
Dr. Mark Stein, an expert on attention-deficit disorders at Children's
National Medical Center in Washington. "Giving medications to children
is a very controversial topic--particularly for very young children.
But we really need to go beyond the headlines and try to understand
what is happening and why."

Ritalin, a stimulant known generically as methylphenidate, has been
available for decades. It is one of a number of drugs that have been
used increasingly in recent years to treat hyperactivity and
attention-deficit problems. Its label warns that the drug should only
be used by children at least 6 years old. But many children younger
than that are given the drug by doctors who prescribe it "off-label,"
an entirely legal but sometimes controversial practice.

Federal officials and health experts said that problems surrounding
dosage and prescription are complex. They cautioned that some children
may not be getting medication who actually need it, while others are
getting too much medication.

But experts such as Stein say they are spotting a disturbing trend
among their pediatric patients. "More and more younger children are
coming in on multiple medications," he said. "That's a cause of great
concern."