Is having poor parents a mental illness that requires heavy medication? Some doctors may think so.

Federally funded researchers from Rutgers and Columbia universities concluded doctors prescribe powerful antipsychotic medication four times higher for children covered by Medicaid than they do for children covered by private insurance. And the children on Medicaid are more likely to have less severe conditions than their more affluent counterparts.

Health advocates are concerned. Antipsychotic medications may be an expedient way to control children's troublesome behavior, but they can also cause serious and sometimes lifelong physical side effects.

An estimated 300,000 American children and teenagers are on such drugs.

The New York Times reports that a pediatric advisory committee to the Food and Drug Administration meets this week to discuss the health risks to all children from antipsychotic drugs. Panel members may recommend warning labels.

A group of Medicaid directors have launched a project called Too Many, Too Much, Too Young. They are investigating ways to reduce prescriptions for antipsychotics among children on Medicaid. They plan to publish a report early next year.

Results from the study by Rutgers and Columbia researchers have been posted on the Web, but they won't be formally published until early next year when they appear in the peer-reviewed journal Health Affairs.

The findings, however, already have people in the medical community talking.

The Times reports some experts are stunned. Other say the study confirms previous indications.

Part of the problem is insurance coverage, the Times reports. Medicaid often pays much less for counseling and therapy than private insurance. That could be because low-income families often have trouble consistently making it to counseling and therapy sessions.

Prescribing a pill becomes a convenient alternative.

"It's easier for patients, and it's easier for docs," Dr. Derek H. Suite, a psychiatrist in the Bronx, tells the Times. "But the question is, 'What are you prescribing it for?' That's where it gets a little fuzzy."

Suite tells the paper he too often sees children on Medicaid on antipsychotic meds they don't seem to need.

An example, he tells The Times, is a 15-year-old girl who was given drugs for having bipolar disorder after a single visit to a clinic.

Suite says the real problem was that she had insomnia and frequent arguments with her mother and stepfather. "Normal
teenager," Suite says he told her. "No scrips for you."

This latest study was based on millions of Medicaid and private insurance claims. Researchers examined records for children in seven large states for the years 2001 and 2004.

But there's a flip side to all this. Antipsychotic medications are expensive. They can cost up to $400 a month. Maybe low-income kids aren't overmedicated.

Could it be that middle-class kids are undermedicated?

"Maybe Medicaid kids are getting better treatment," Dr. Gabrielle Carlson, a child psychiatrist and professor at the Stony Brook School of Medicine, tells the Times. "If it helps keep them in school, maybe it's not so bad."

Related: Antipsychotics for Child and Teen Bipolar Disorder, Over-Medicated