INTRODUCTION TO PSYCHOTROPIC MEDICATION FOR PEDIATRIC USE

INTRODUCTION TO PSYCHOTROPIC MEDICATION FOR PEDIATRIC USE

Psychiatric disorders affect children in their abilities to learn, behave, and adapt to dealing with daily stressors. According to the Centers for Disease Control and Prevention, an estimated 1 in 6 children between the ages of 2 through 8 years are diagnosed with some type of mental, behavioral, or developmental disorder; of which some common types include attention-deficit/hyperactivity disorder (ADHD), anxiety, eating disorders, mood disorders, or schizophrenia.1, 2

For children diagnosed with psychiatric disorders, the mainstay for treatment includes psychotherapy, or treatment that relies on patient/caregiver-provider conversations to understand and resolve problems, adequate sleep, balanced diet, exercise and the use of psychotropics, or medications that help to decrease or manage symptoms to allow for improved daily functioning. In todays discussion, we will focus on the use of psychotropic medications.

The use of psychotropic medications follows an initial consult between the patient, parent or caregiver, and the provider. Before a medication is prescribed, the physician will evaluate and assess all symptoms, their severity and will weigh the benefits and risks for the use of any product. When starting psychotropic therapy, your physician will let you know what symptom the medication is targeting, what it will help alleviate, and any potential side effects that may be associated with the product.

Some of the most commonly prescribed medication classes include:

  • ADHD Medications
  • Antidepressant Medications
  • Antipsychotic Medications
  • Mood Stabilizers and Anticonvulsant Medications
  • Anti-Anxiety Medications
  • Sleep Medications

Compared to other medication classes used to treat non-mental health disorders, most psychotropic medications work by altering or stabilizing brain chemistry. Thus, patients and caregivers should be aware that results often vary by patient, can take a few days or weeks to see an effect, and that medications should not be discontinued unless directed by a physician. Changes in behavior, such as eating, sleeping, weight gain/loss, or communication toward others may often be signs that a medication is beginning to have effects in the body. Throughout this time, it is important for parents and caregivers to monitor any negative behaviors seen in the child, such as feelings of depression or self-worthlessness; as these can be signs of suicidal ideation. Some medication classes, such as antidepressants, have a Black Box warning of suicidal ideation, and can be identified by knowing a few of the warning signs: talking about wanting to die, plans to purchase weaponry, feeling trapped or a burden to others, isolation, or extreme mood swings.3 If any of these negative symptoms are experienced, it is important to let your provider know immediately. As is with other medication classes, if a patient experiences any type of rash, hives, or swelling of the eyes, face, lips, tongue, or throat, parents or caregivers are advised to call your physician and go to your nearest emergency room immediately, as these may be signs of an allergic hypersensitivity that may require immediate medical attention.

Achieving the optimal psychotropic medication regimen to stabilize psychiatric symptoms often requires single or multiple changes to the regimen, which may include increasing or decreasing the doses, adding other medication or switching from one product to another. As the optimal regimen is achieved and symptoms are alleviated, patients often feel that they may no longer require to continue taking their medication regimen and stop abruptly, a common mistake that increases the likelihood for symptoms to come back. It is important to remember not to discontinue any medication without first speaking with your provider, as they will be able to safely and appropriately monitor the patient for any changes to the regimen.

REFERENCES:

1 Centers for Disease Control: Data and statistics on children’s mental health. Available at: https://www.cdc.gov/childrensmentalhealth/data.html. Accessed April 30, 2019.

2 Mayo Clinic: Childrens health. Mental illness in children: Know the signs. Available at: https://www.mayoclinic.org/healthy-lifestyle/childrens-health/in-depth/mental-illness-in-children/art-20046577. Accessed April 30, 2019.

3 Suicide Prevention Lifeline: Know the warning signs. Available at: https://suicidepreventionlifeline.org/how-we-can-all-prevent-suicide. Accessed April 30, 2019.