Why millions of US children move from ADHD pills to powerful psychiatric drugs

Why millions of US children move from ADHD pills to powerful psychiatric drugs

For many families, the ADHD label appears long before a child fully understands their own behaviour. In schools across the United States, teachers and administrators frequently flag inattentiveness, restlessness or disruptive conduct as potential ADHD. Parents, worried about academic performance or disciplinary action, often feel cornered into seeking medical help. As the article recounts, Danielle Gansky’s journey began at age seven when her school warned her mother that she could fall behind or be removed without intervention. A stimulant was prescribed immediately, the Wal Street Journal reported.

Her story is far from unique. About 7.1 million American children have been diagnosed with ADHD, and roughly half take medication for it. These prescriptions increasingly occur at extremely young ages, sometimes even in preschool, despite paediatric guidelines urging behavioural therapy first. But in practice, therapy can be impossible to access — with months-long waitlists, scarce providers, and high costs. Medication becomes the only immediate solution.

When one pill causes problems — and another follows

The hidden turning point in many cases is what doctors describe as side-effect prescribing. Children put on stimulants may experience insomnia, anxiety, irritability, aggression or emotional blunting. Instead of reviewing the original decision, clinicians often prescribe a second medication to manage the new symptoms.

This is how young children find themselves on antidepressants, anti-anxiety drugs or even antipsychotics. Some combinations are off-label for their age, meaning they were never adequately studied in young brains. Several children described in the report had been prescribed two, three or more psychiatric medicines simultaneously before the age of six.

Researchers warn that the long-term neurological impact of these combinations is poorly understood. Antipsychotics in particular pose risks, including weight gain, metabolic issues, movement disorders and possible cognitive effects. Yet more than 23 percent of children who began ADHD drugs in 2019 were taking at least two psychiatric medications four years later.

The gaps in America’s mental-health system

A recurring theme in the article is structural failure rather than parental negligence. Many families face a shortage of child psychologists, developmental specialists and behavioural-therapy centres. Some parents say they called every therapist within driving distance and still couldn’t secure an appointment.

In these “mental-health deserts,” primary-care doctors, physician assistants or nurse practitioners — often without specialist training — become the default prescribers. They are also under pressure from schools expecting quick behavioural fixes. Several parents admitted they agreed to medication because they feared expulsion from preschools or daycare centres.

Misdiagnosis further complicates the picture. Behaviour stemming from trauma, instability at home or untreated anxiety can look like ADHD. Without enough time for evaluation, the root cause is missed and the child is placed on medication that may worsen the underlying distress.

Children who grew up medicated — and now question it

One of the most striking parts of the report comes from young adults who had been medicated since childhood. Many describe feeling numb, slow, irritable or disconnected. Several said they were too young to challenge their doctors, while parents believed professionals knew best.

Some, like Danielle, spent their teens and twenties moving between medications, trying to manage new symptoms created by earlier prescriptions. Others, like Tyrell and Jordan, eventually improved only after stepping off drugs and receiving targeted behavioural therapy or family-based counselling.

Their stories highlight the absence of long-term studies on how layered psychiatric medications affect children as they grow into adulthood.

The deeper lesson: ADHD treatment remains essential — but the system is broken

Experts emphasise that ADHD medication can be life-changing and lifesaving when used responsibly and with proper oversight. What concerns them is not the existence of these drugs, but the speed, frequency and layering with which they are used — especially in very young children.

The rise of multidrug treatment reflects a national crisis: schools under strain, parents desperate for help, clinicians overstretched, and children caught in the middle. Without major investment in paediatric mental-health services and behavioural therapy, the drug cascade will continue — not because it is the best solution, but because it is the only one many families can access.