Giving a child medication- not at the top of anyone’s list of favorite things to do. However, in some situations, it might be the best option, especially when it comes to serious mental health issues. Of course, as a parent, you want to be sure that it’s the “right” thing to do. Keep in mind that what’s “right” for your child may not be the same choice for someone else’s child, and everyone comes with opinions and experiences which influence their decisions.
Maybe you want to consider medication because your child or adolescent is experiencing a significant level of impairment in his or her life. Maybe therapy or the other supports that you’ve put in place aren’t helping enough. It might show up as an adolescent who isn’t enjoying things that they used to, is isolating themselves, isn’t sleeping enough or sleeping so much that they can’t participate in anything. It could also look like your child can’t learn what needs to be learned because his/her body is moving all around the room or they can’t pay attention to the lesson being taught. These are just examples of how mental illness might affect a child or adolescent in significant ways. These are the situations in which medication might need to be used.
As a parent, you should certainly find a provider who can conduct a thorough evaluation of your child/adolescent before they make any recommendations for treatment. This provider could be a child and adolescent psychiatrist, a psychologist, or any other licensed therapist. However, if you want your child to be evaluated by someone who can consider the medical aspects and also prescribe medications, then a child psychiatrist might be your best option.
As you venture into medication as a part of the treatment, consider the following 6 things about medication.
- They don’t work for everyone.
Starting medications is like starting an elimination diet, where the goal is to figure out what you’re allergic to by not eating certain food for a short period of time. Sometimes, you’ll find the triggering food (or medication in this case) and the amount of it (or dose) in a short period of time. For others, it can take months or longer. The process of finding the right medication and dose that works also takes time, and it’s hard, if not impossible, to find a “quick fix”.
Your child’s doctor will make adjustments to doses and may recommend changing the medication to something else if there are side effects or if it’s at the highest dose that’s safe to give and if things still aren’t much better. Be patient…when medicine works, you or your child will know it.
Not everyone responds with a positive outcome from medication. For some people, after several unsuccessful trials of medications, the doctor may suggest that other interventions become the main form of treatment, such as therapy or other treatments.
- Most medications used in mental health are not approved by the FDA for children and adolescents.
What does that mean and is it important? The Food and Drug Administration (FDA) has a process by which they determine whether or not a medication will be approved for its use based on its safety and effectiveness. Much of this decision is based on research that is submitted to them by pharmaceutical companies who develop new drugs. Not much research is done on children and adolescents because of the risks of a new drug on a developing brain. That makes sense.
However, that also leaves us with the fact that if research isn’t getting done in younger people, then the FDA won’t “approve” a medication for the lower age ranges, even if the same medicine was shown to be effective in adults. So, it’s important for a provider to use FDA approved medications when first trying medication, but know that they will most likely have to use medications “off-label”, which means that they don’t’ have the FDA approval for that use in that age range.
- Not every child needs to take medication for mental health issues.
Even if you take your child to see a child and adolescent psychiatrist and you think they might need medication, you might hear something different after the evaluation. Your child would need to experience significant impairment in different areas of their life. The illness also has to be in the moderate to severe range in order for medication to be recommended.
The provider might also recommend therapy or other interventions along with the medication, since we know that medication may not work for every child and many people improve more when medication is combined with therapy. If medication isn’t recommended, then it’s possible that therapy alone might be sufficient. Additional options include yoga, meditation, school interventions, healthy diet, and better sleep habits among others.
- Just because there’s a long list of side effects, it doesn’t mean you’ll have them.
All drugs have possible side effects, and pharmaceutical companies are required to list everything that someone in the research trial experienced as a side effect. Some people don’t notice anything though. For others, the side effect might be a just mild problem that lasts for a short period of time, such as a headache or stomach upset. Sometimes, side effects might occur only when taking higher doses of the medication. There are some serious side effects of certain medications. Those will need more close attention, and your provider should let you know about them before your child begins the medication.
One thing to note about our internal states as your child (or you) start a new medicine, if you expect to have side effects, then chances are that you’ll notice some sort of side effect because your mind is already biased towards having it. In short, you’ll be “looking for” a negative experience and will then have it. It’s important to keep an open mind during the process. It’s also important to keep an open line of communication with the provider about what to expect and what to do if there is a side effect.
- Starting and stopping medication needs supervision by the prescribing provider.
Taking medications for mental health issues is not something to take lightly. There is a process to starting medication, getting to a dose that works well, and, for some children, stopping medications when things have improved. This process is something that requires medical training and needs careful supervision. Due to the risk of possible side effects and other serious issues that can arise, it’s important to not change medications on your own. You should also make contact with your provider if you have concerns about the process or concerns about side effects.
- It’s not safe to share medications.
You might think it’s okay to have your children share their asthma inhaler or their medication for ADHD if one of them has run out. Let’s be clear- medications should never be shared by family members or friends, given to anyone else, or misused by the person they are prescribed for. This can be very risky for both the person whose medication it is (risk of running out, consequences of that, inability to get an early refill) and risks for the person who takes medicine that is not prescribed (health risks, legal risks). Many medications are also considered “controlled substances”, which need to be carefully monitored by a provider and parent due to the risk of misuse and addiction. As a parent, it’s also your responsibility to make sure that you can account for and secure all of the medication in the house. There should be little to no chance of someone taking a medication that does not belong to them, and if someone’s medication, especially a controlled substance, is missing, then their doctor needs to be notified right away.
