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Psychiatric
medications can be an effective part of the treatment for
psychiatric disorders of childhood and adolescence. In recent
years there have been an increasing number of new and different
psychiatric medications used with children and adolescents.
Research studies are underway to establish more clearly which
medications are most helpful for specific disorders and presenting
problems. Clinical practice and experience, as well as research
studies, help physicians determine which medications are most
effective for a particular child. Before recommending any
medication, the psychiatrist (preferably a child and adolescent
psychiatrist) should conduct a comprehensive diagnostic evaluation
of the child or adolescent. The youngster's presenting psychiatric
symptoms along with past response to medications and also
consideration of possible side effects will determine the
choice of medication. Psychiatric medication should only be
used as part of a comprehensive treatment plan.
Stimulant
Medications: Stimulant medications are often useful as
part of the treatment for attention deficit hyperactive disorder
(ADHD). Examples include: Dextroamphet- amine (Dexedrine,
Adderal), Methylphenidate (Ritalin), and Pemoline
(Cylert).
Antidepressant
Medications: Antidepressant medications are used in the
treatment of depression, school phobias, panic attacks, and
other anxiety disorders, bedwetting, eating disorders, obsessive-compulsive
disorder, personality disorders, posttraumatic stress disorder,
and attention deficit hyperactive disorder. There are several
types of antidepressant medications (tricyclics, serotonin
reuptake inhibitors, monoamine oxidase inhibitors and atypical).
Examples of tricyclic antidepressants (TCA's) include:
Amitriptyline (Elavil), Clomipramine (Anafranil),
Imipramine (Tofranil), and Nortriptyline (Pamelor).
Examples of serotonin reuptake inhibitors (SRI's) include:
Fluoxetine (Prozac), Sertraline (Zoloft), Paroxetine
(Paxil), Fluvoxamine (Luvox), Venlafaxine (Effexor),
and Citalopram (Celexa). Examples of monoamine oxidase
inhibitors (MAOI's) include: Phenelzine (Nardil),
and Tranylcypromine (Parnate). Examples of atypical antidepressants
include: Bupropion (Wellbutrin), Nefazodone (Serzone),
Trazodone (Desyrel), and Mirtazapine (Remeron).
Antipsychotic
Medications: Antipsychotic medications can be helpful
in controlling psychotic symptoms (delusions, hallucinations)
or disorganized thinking. These medications may also help
muscle twitches ("tics") or verbal outbursts as seen in Tourette's
Syndrome. They are occasionally used to treat severe anxiety
and may help in reducing very aggressive behavior. Examples
of traditional antipsychotic medications include: Chlorpromazine
(Thorazine), Thioridazine (Mellaril), Fluphenazine
(Prolixin), Trifluoperazine (Stelazine), Thiothixene
(Navane), and Haloperidol (Haldol). Newer antipsychotic
medications (also known as atypical or novel) include: Clozapine
(Clozaril), Risperidone (Risperdal), Quetiapine
(Seroquel), Olanzapine (Zyprexa), and Ziprasidone
(Zeldox).
Mood
Stabilizers and Anticonvulsant Medications: Mood stabilizers
may be helpful in treating manic-depressive episodes, excessive
mood swings, aggressive behavior, impulse control disorders
and severe mood symptoms in schizoaffective disorder and schizophrenia.
Lithium (lithium carbonate, Eskalith) is an example
of a mood stabilizer. Some anticonvulsant medications can
also help control severe mood changes. Examples include: Valproic
Acid (Depakote, Depakene), Carbamazepine (Tegretol),
Gabapentin (Neurontin), and Lamotrigine (Lamictil).
Anti-anxiety
Medications: Anti-anxiety medications may be helpful in
the treatment of severe anxiety. There are several types of
anti-anxiety medications: benzodiazepines; antihistamines;
and atypicals. Examples of benzodiazepines include: Alprazolam
(Xanax), lorazepam (Ativan), Diazepam (Valium),and
Clonazepam (Klonopin). Examples of antihistamines include:
Diphenhydramine (Benadryl), and Hydroxizine (Vistaril).
Examples of atypical anti-anxiety medications include: Buspirone
(BuSpar), and Zolpidem (Ambien).
Sleep
Medications: A variety of medications may be used for
a short period to help with sleep problems. Examples include:
SRI anti-depressants, Trazodone (Desyrel), Zolpidem
(Ambien), and Diphenhydramine (Benadryl).
Miscellaneous
Medications: Other medications are also being used to
treat a variety of symptoms. For example: clonidine (Catapres)
may be used to treat the severe impulsiveness in some children
with ADHD and guanfacine (Tenex) for "flashbacks" in
children with PTSD.
When prescribed
appropriately by an experienced psychiatrist (preferably a
child and adolescent psychiatrist) and taken as directed,
medication may reduce or eliminate troubling symptoms and
improve daily functioning of children and adolescents with
psychiatric disorders.
For additional
information see Facts for Families: #21 Psychiatric
Medication for Children and Adolescents: Part I - How Medications
Are Used, #51 Psychiatric Medication for Children and Adolescents:
Part III - Questions to Ask. See also: Your Child
(1998 Harper Collins)/Your Adolescent (1999 Harper
Collins).
Article
#29 Updated 2/00
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