Part 1: How Medications Are Used
Medication can be an effective part of the treatment for several
psychiatric disorders of childhood and adolescence. A 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 treating psychiatric
illnesses in children and adolescents. He or she should fully
explain the reasons for medication use, what benefits the medication
should provide, as well as unwanted side-effects or dangers and
other treatment alternatives.
Psychiatric medication should not be used alone. As undertaking
a medication trial may mean adjusting doses of medicine over time
and/or the use of additional medications to meet an individual
youngster's needs, the use of medication should be part of a comprehensive
treatment plan, usually including psychotherapy, as well as parent
guidance sessions.
Before recommending any medication, the child and adolescent
psychiatrist interviews the youngster and makes a thorough diagnostic
evaluation. In some cases, the evaluation may include a physical
exam, psychological testing, laboratory tests, other medical tests
such as an electrocardiogram (EKG) or electroencephalogram (EEG)
, and consultation with other medical specialists.
Child and adolescent psychiatrists stress that medications which
have beneficial effects also have unwanted side effects, ranging
from just annoying to very serious. As each youngster is different
and may have individual reactions to medication, close contact
with the treating physician is recommended. Do not stop or change
a medication without speaking to the doctor. Psychiatric medication
should be used as part of a comprehensive plan of treatment, with
ongoing medical assessment and, in most cases, individual
and/or family psychotherapy. When prescribed appropriately
by a psychiatrist (preferably a child and adolescent psychiatrist),
and taken as prescribed, medication may reduce or eliminate troubling
symptoms and improve the daily functioning of children and adolescents
with psychiatric disorders.
Medication may be prescribed for psychiatric symptoms and disorders,
including, but not limited to:
- Bedwetting: If it persists regularly after age 5 and
causes serious problems in low self-esteem and social interaction.
- Anxiety: School refusal, phobias, separation or social
fears, generalized anxiety, or posttraumatic stress disorders,
if it keeps the youngster from normal daily activities.
- Attention deficit hyperactivity disorder: Marked by
a short attention span, trouble concentrating and restlessness.
The child is easily upset and frustrated, often has problems
getting along with family and friends, and usually has trouble
in school.
- Obsessive-compulsive disorder: Recurring obsessions
(troublesome and intrusive thoughts) and/or compulsions (repetitive
behaviors or rituals such as handwashing, counting, checking
to see if doors are locked) which are often seen as senseless
but which interfere with a youngster's daily functioning.
- Depressive disorder: 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.
- Bipolar (manic-depressive) disorder: 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, and deterioration of personal habits. May
be seen in developmental disorders, severe depression, schizoaffective
disorder, schizophrenia, and some forms of substance abuse.
- Autism: (or other pervasive developmental disorder,
such as Asperger's Syndrome) Characterized by severe deficits
in social interactions, language, and/or thinking or ability
to learn, and usually diagnosed in early childhood.
- Severe aggression: May include assaultiveness, excessive
property damage, or prolonged self-abuse, such as head-banging
or cutting.
- Sleep problems: Symptoms can include insomnia, night
terrors, sleep walking, fear of separation, anxiety.
Next Page ->
Medication, Part 2
Daycare.com would like to thank American
Academy of Child and Adolescent Psychiatry for this information
in striving to make daycare and childcare a more productive and
efficient service. You can contact them at: 3615 Wisconsin Ave.,
N.W., Washington, D.C. 20016-3007 voice: 202-966-7300 fax: 202-966-2891.
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