Medications can be a lifesaver when it comes to behavioral or emotional problems that have not yet adequately responded to (or treated with) appropriate non-medical interventions. Though there are conditions for which medication is the primary treatment, it is generally our goal to use medications as a bridge for the child until they can learn to cope with their challenges on their own – often through therapy but sometimes just through normal growth and maturation.
Continuing Medications
Many children come to us already on a medication regimen, and particularly, for those long-term regimens which have been effective, the general approach will be to maintain them with periodic evaluations to assess the need for modification. If it is warranted, we may suggest an alternative to an established regimen if there is evidence of a more effective or safer agent. It is not uncommon for developments to occur in this field which changes treatment practices so an old regimen, while effective, may benefit from change informed by recent medical advances.
Medication Failure
On the opposite end of the spectrum are those children who may have failed multiple trials of medications or have responded inadequately or only for a limited period. In these cases, it becomes very important to construct a complete medication and medical history of the child. Often it has been the case where there has been missed or misidentified medical conditions which mimic or exacerbate a psychiatric condition, so the value of a thorough history an evaluation cannot be overstated.
Unintended Consequences
Even if a safe and effective regimen is identified, the idea of taking medications can cause some distress in patients. Particularly with children of a certain age who are developing a sense of self, the introduction of medication can cause confusion. The child can interpret their parents requesting to take medication as an indication that there is a defect in themselves; or worse, may perceive being misunderstood, unappreciated, or being controlled.
This is why the effort is made to educate the parents and the patient when prescribing medication. It is essential that everyone involved understand the purpose of the medication, what its intended effects are, what it cannot do and the plan on how and when the patient will eventually be weaned off the medication.
Appropriate Usage
Medications are most often the intervention that yields the quickest response but it needs to be kept in mind that, in most cases, the goal is not to just find the idea regimen but also to manage the patients’ and parents’ concerns, expectations and significance of medication that is being prescribed.