Medication may be an effective part of the treatment for several psychiatric disorders for childhood and adolescence. The doctor’s recommendation to use medication often raises many concerns and questions in both the parents and the youngster. The physician who recommends medication should be experienced in using it to treat psychiatric illnesses in children and adolescents. He or she should fully explain the reasons for its use, what benefits it should provide, its unwanted effects or dangers, and treatment alternatives.
Psychiatric medication should not be used alone. It should be part of a comprehensive treatment plan, usually including medical psychotherapy.
Before recommending any medication, the child and adolescent psychiatrist examines the youngster and makes a thorough diagnostic evaluation. In some cases, the evaluation will include psychological testing, laboratory tests, and consultation with other medical specialists.
Psychiatric medications may be prescribed for a number of problems. From less to more serious, these disorders include:
- Bedwetting – if it persists regularly after age 5 and causes serious problems in low self-esteem and social interaction.
- Specific fears (phobias) or general anxiety – if it keeps the youngster from normal daily activities.
- Attention deficit hyperactive disorder – marked by a short attention span, trouble concentrating and restlessness. The child is easily upset and frustrated, and usually has trouble in school.
- School phobia (separation anxiety) – a fear of leaving home. The child refuses to go to school or repeatedly feels too sick to go.
- Depression – lasting feelings of sadness, helplessness, hopelessness, unworthiness and guilt, inability to feel pleasure, a decline in school work and changes in sleeping and eating habits.
- Eating disorder – either self-starvation (anorexia nervosa) or binge eating and vomiting (bulimia), or a combination of the two.
- Manic-depressive condition - periods of depression alternating with manic periods, which may include irritability, “high” or happy mood, excessive energy, behavior problems, staying up late at night, and grand plans.
- Psychosis – symptoms include irrational beliefs, paranoia, hallucinations (seeing things or hearing sounds that don’t exist) social withdrawal, clinging, strange behavior, extreme stubbornness, persistent rituals, deterioration of personal habits.
There are major categories of psychiatric medication:
- Stimulant medication - such as dexedrine or methylphenidate (Ritalin). Useful as part of the treatment for attention deficit hyperactive disorder.
- Anti-depressants – used in the treatment of serious depression, school phobias, some other serious anxiety disorders, bedwetting, some bulimic-type eating disorders and attention deficit hyperactive disorder.
- Antipsychotic medication (“major tranquilizers”) – such as Haldol, Stelazine, or Thorazine. Usually gives more inner control to the psychotic patient; stops or at least takes the panic out of irrational beliefs and hallucinations.
- Lithium and carbamazepine (Tegretol) - very helpful in treating and preventing manic-depressive episodes.
- Anti-anxiety medications - short-term use for certain conditions associated with high anxiety. Their usefulness in children has not been well studied, so they should be prescribed only by a physician with experience in their use.
Child and adolescent psychiatrists stress that medications which have beneficial effects also have unwanted side effects, ranging from just annoying to very serious.
Psychiatric medication should be used as part of a comprehensive plan of treatment, with ongoing evaluation and, in most cases, medical psychotherapy. When prescribed appropriately by an experienced physician, medication may help children and adolescents with psychiatric disorders feel restored to their normal selves.
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Copyright © 1997 by the American Academy of Child & Adolescent Psychiatry.
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