Johnny's New Snack: Milk, Cookies and Prozac

When a kid is acting his age in a fancy restaurant, bumping into chairs and tripping waiters, most everyone — other than that child's parents — agrees: Send the kid home and next time hire a baby-sitter. But according to a new report published in the Journal of the American Medical Association, if a certain type of child psychiatrist is in the restaurant, that energetic kid might leave with a fistful of prescriptions for some very grown-up psychoactive drugs. The study, conducted by researchers at the University of Maryland, raises serious concerns among pediatricians; it found a 50 percent increase between 1991 and 1995 in the number of children aged two to four who were prescribed psychiatric, behavior-changing drugs such as Ritalin and Prozac.

The study raises the question of whether children are being prescribed drugs for behavior that in earlier times would have been dismissed as bratty or "kids just being kids." TIME medical contributor Dr. Ian Smith is troubled by the implications of the survey, but he also has scientific concerns about the methodology. "The researchers did a good job of getting a geographically and medically diverse sampling, but we have to be careful and ask ourselves, does this sample represent a microcosm of society?" says Dr. Smith. "Can we extrapolate a national trend from these groups' behaviors?" With these caveats in mind, doctors and parents should take note of two critical points presented by the Maryland study. "First, it's extremely troubling that young kids are being prescribed drugs that have serious side effects and that have never been studied in that age group," he says. The trend toward drugging so-called "hyperactive" children may have economic roots as well, as medication is generally far less expensive than counseling. "We absolutely don't want meds to become a quickfix substitute for meaningful, albeit more costly, long-term therapy," says Dr. Smith. Because in the worst-case scenario, these toddlers on drugs could foretell a future peopled entirely by lifelong, glazed-over Prozac users who have no in-built abilities to deal with stress or sadness.