National analyses reveal widespread psychotropic prescribing to infants, toddlers, and young children. CCHR is urging immediate federal oversight, calling the trend a systemic failure, placing children at chemical risk.
By CCHR International
The Mental Health Industry Watchdog
December 1, 2025
Tens of thousands of American children who begin with a prescription for Attention Deficit Hyperactivity Disorder (ADHD) drugs ultimately end up on multiple powerful psychiatric drugs, sometimes even before they are old enough to attend elementary school. A new Wall Street Journal analysis of 2019–2023 Medicaid data found that children aged 3 to 14 who were started on an ADHD drug were more than five times as likely to be prescribed additional psychiatric drugs within four years compared to peers not on ADHD drugs. Most of the added drugs were antidepressants or antipsychotics—agents associated with severe, sometimes irreversible, side effects.[1]
However, the mental health industry watchdog, Citizens Commission on Human Rights International (CCHR), conducted its own review of state-by-state Medicaid data through Freedom of Information Act (FOIA) requests, and the findings were even more alarming. From the 32 states that provided records, nearly 3 million Medicaid-enrolled children ages 0–17 were prescribed psychiatric drugs in 2023, at a cost of $1.78 billion. Among them were 270,196 toddlers and preschool-aged children—an especially vulnerable population for whom many of these drugs are not FDA-approved. Because 18 states failed to provide data, the true national total is almost certainly far higher, likely surpassing 4 million children.
In the comprehensive breakdown of Medicaid child beneficiaries, more than 1.4 million were prescribed stimulants, 920,411 were given antidepressants, 605,746 received antianxiety drugs, 465,599 were put on antipsychotics, and 384,299 were prescribed mood stabilizers.
The Wall Street Journal reports that, according to 2021 federal data, 7.1 million American children aged 3 to 17 have been given an ADHD diagnosis. Roughly half are estimated to be on ADHD drugs. Data obtained by CCHR from IQVIA, a global healthcare analytics firm, also showed that 3.15 million U.S. children (0–17) were prescribed ADHD stimulants in 2020, including 58,000 children under 5 years old.
Yet the FDA approves these drugs only for children six and older, meaning young children are being prescribed potent stimulants “off label” (without FDA approval) and without long-term safety research.
CCHR’s Medicaid data collection three years later indicates the situation has not merely continued but likely worsened into a full-scale public health failure demanding immediate federal intervention.
For all psychiatric drugs for 0-17 age group, the figures are even more alarming: 6.1 million.
- 85,003 infants aged 0–1
- 138,822 toddlers aged 2–3
- 215,120 preschoolers aged 4–5
- 2,652,554 6-12 years
- 3,188,988 13-17 years.[2]
Jan Eastgate, president of CCHR International, says that these prescribing patterns reveal a federally funded “drug and polypharmacy pipeline”—one that urgently demands congressional and state oversight to protect children from what the watchdog calls “chemical assault and negligence disguised as care.”
ADHD stimulant drugs carry a black box warning that they can cause addiction, even when taken exactly as prescribed.[3] A recent American Journal of Psychiatry study found that high doses of certain ADHD stimulants were associated with a more than five-fold increased risk of psychosis or mania.[4]
Danish physician and researcher Dr. Peter C. Gøtzsche warns that stimulants can also suppress normal childhood emotional and behavioral expression, causing apathy or indifference. In some studies, more than half of children developed depression or compulsive, and meaningless behaviors while taking them.[5]
Antidepressants also carry their own black box warning for suicidal thoughts and behavior in children and young adults.[6]
Antipsychotics are linked to metabolic damage, violent behavior, and neurological disorders.[7] One of their most severe effects is tardive dyskinesia (TD)—a disfiguring movement disorder caused by antipsychotics. Its symptoms resemble Parkinson’s disease: involuntary movements of the lips, tongue, jaw, fingers, toes, or other body parts. TD can persist long after the drug is stopped—sometimes permanently. It is a reported risk in the pediatric population.[8]
Even worse, individuals developing TD are often prescribed more psychiatric drugs (Ingrezza and Austedo) to counter the symptoms, exposing them to additional risks such as blurred vision, tremors, irregular heartbeat, drooling, restlessness, or akathisia—a well-documented driver of extreme agitation and suicidal or violent behavior.[9]
Eastgate says the expanding trend of drugging children with cocktails of psychotropics constitutes a national emergency: “This is a chemical assault on children, masking the real causes of their distress and too often worsening the very problems these drugs claim to treat. Federal and state intervention is urgently needed to abolish these negligent polypharmacy practices.”
Clinical experts agree the system is out of control. Alexandra Perez, a clinical psychologist at Emory University School of Medicine, told The Wall Street Journal she has seen children as young as four years old who were already on multiple psychiatric drugs. Many of these children had histories of trauma or adversity that were mislabeled as ADHD and drugged instead of addressed through non-drug support.
Polypharmacy Accelerating for Two Decades
A 2021 review in Frontiers in Psychiatry summarized more than 20 years of research documenting substantial growth in pediatric psychotropic polypharmacy. In the studies reviewed:
- Up to 300,000 U.S. youth were found to be receiving three or more psychiatric drug classes simultaneously in certain Medicaid datasets.
- Factors identified as driving this included: dominance of the biological model in child psychiatry, unsupported assumptions about multi-drug “efficacy,” under-recognition of metabolic and neurological adverse effects and infrequent or absent deprescribing
- In one large Medicaid study of individuals aged 2–24 treated for ADHD: use of two or more ADHD drugs rose from 16.8% to 20.5%; prescriptions for two or more additional psychotropic classes increased from 26.0% to 40.7%
- Another study reported that 73.1% of children aged 6–18 receiving ADHD drugs had psychotropic polypharmacy, versus 26.9% in younger (2–5) and older (19–24) groups.[10]
WSJ: Providers Routinely Stacking Drugs on Children
Four years after those findings, the Wall Street Journal shows the trend has only worsened, as confirmed also by CCHR’s own Medicaid analysis. Between 2019 and 2022:
- Nearly 5,000 providers prescribed ADHD drugs to at least 100 children each
- On average, 25% of these children also received one or more additional psychiatric drugs
- By 2023, 39,000 children (23%) on ADHD drugs were taking two or more psychiatric drugs simultaneously and more than 4,400 were on four separate drugs at once.
“Not Care—Harm”
CCHR, founded 56 years ago by the Church of Scientology and professor of psychiatry Thomas Szasz, said the latest data reveal an entrenched national failure to protect children. “Pumping kids with ADHD stimulants—often amphetamines—combined with mind-altering antidepressants, antipsychotics, or sedative-hypnotics, is evidence of a mental health system that has normalized harm under the guise of treatment,” Eastgate said. “This is not care—it is harm. The practice should be abolished.”
[1] Shalini Ramachandran, et al., “Millions of Kids Are on ADHD Pills. For Many, It’s the Start of a Drug Cascade,” Wall Street Journal, 20 Nov. 2025,https://www.wsj.com/health/wellness/kids-adhd-drugs-medication-06dfa0b7?st=oRRSe8&reflink=desktopwebshare_permalink
[2] https://www.cchrint.org/psychiatric-drugs/children-on-psychiatric-drugs/; https://www.rxlist.com/ingrezza-side-effects-drug-center.htm#professional; https://www.drugs.com/sfx/ingrezza-side-effects.html
[3] https://www.cchrint.org/2023/05/16/fda-finally-adds-addiction-to-black-box-warning-on-adhd-drugs/; “FDA updating warnings to improve safe use of prescription stimulants used to treat ADHD and other conditions,” FDA, 11 May 2023, https://www.fda.gov/media/168066/download
[4] https://www.cchrint.org/2024/09/20/new-study-warns-of-high-dose-adhd-drugs-inducing-psychosis/; Akshay Syal, M.D.,” High doses of ADHD drugs linked to a greater risk of psychosis,” NBC News, 12 Sept. 2024, https://www.nbcnews.com/health/mental-health/high-doses-adhd-drugs-linked-greater-risk-psychosis-rcna170707
[5] Peter C. Gøtzsche, MD, “Critical Psychiatry Textbook, Chapter 9: ADHD (Part Two),” Mad In America, 14 Aug. 2023, https://www.madinamerica.com/2023/08/critical-psychiatry-textbook-chapter-9-part-two/
[6] https://www.cchrint.org/2024/10/11/cchr-wants-increased-consumer-awareness-about-prescriptions-for-violence/; Alex Alikiotis “The Link Between Antipsychotics And Aggressive Behavior: Understanding The Potential Causes Of Violence,” MedShun 24 Dec. 2023, https://medshun.com/article/why-do-antipsychotics-cause-violence
[7] Mathews M, Gratz S, Adetunji B, George V, Mathews M, Basil B., “Antipsychotic-induced movement disorders: evaluation and treatment,” Psychiatry (Edgmont), 2005 Mar;2(3):36-41, https://pmc.ncbi.nlm.nih.gov/articles/PMC3004713/; Alex Alikiotis “The Link Between Antipsychotics And Aggressive Behavior: Understanding The Potential Causes Of Violence,” MedShun, 24 Dec. 2023, https://medshun.com/article/why-do-antipsychotics-cause-violence; William B. Daviss, M.D., et al., “Use of Antipsychotic Medications for Nonpsychotic Children: Risks and Implications for Mental Health Services,” Psychiatric Services, Volume 67, Number 3, 4 Jan. 2016, https://psychiatryonline.org/doi/10.1176/appi.ps.201500272
[8] Frank M C Besag et. al., “Tardive Dyskinesia with Antipsychotic Medication in Children and Adolescents: A Systematic Literature Review,” Drug Safety, Nov. 2024, https://pubmed.ncbi.nlm.nih.gov/38862692
[9] https://www.cchrint.org/2021/10/11/consumers-beware-of-antipsychotics-long-term-debilitating-effects/
[10] Julie M. Zito, “Psychotropic Polypharmacy in the US Pediatric Population: A Methodologic Critique and Commentary,” Frontiers in Psychiatry, 14 June 2021, https://pmc.ncbi.nlm.nih.gov/articles/PMC8236612/
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