Dr. Henry Paul, MD

Psychiatrist, Author and Educator

Tag Archives: antipsychotics

PSYCHIATRIC DRUGS FOR BABIES – REALLY?

December 14th, 2015

Is it possible that psychiatric medications tested on adults and meant to treat adult psychiatric disorders are now being used to treat psychiatric disorders in children younger than two years old? So it seems according to The New York Times story last week. “Still in a Crib, Yet Being Given Antipsychotics” by Alan Schwarz.

12285416_sAccording to the NYT story, “Cases like that of Andrew Rios, in which children age 2 or younger are prescribed psychiatric medications to address alarmingly violent or withdrawn behavior, are rising rapidly, data shows. Many doctors worry that these drugs, designed for adults and only warily accepted for certain school-age youngsters, are being used to treat children still in cribs despite no published research into their effectiveness and potential health risks for children so young.”

Using drugs “off-label” for treating all kinds of conditions from cancer to ADHD has become so common that almost every drug at some point is prescribed off-label. Off-label means the medication is being used in a manner not specified in the FDA’s approved packaging label or insert. Off-label prescribing isn’t necessarily bad. It can be beneficial.

In child and adolescent psychiatry, the majority of the drug prescribing is done off-label. Few medications are approved for young people, but making these valuable medications unavailable because drug companies have not tested them for all conditions and populations would cause a lot of prolonged suffering and even deaths. This is the case for hundreds of drugs, not just psychotropic medications. Studies have been coming out showing the helpfulness of psychotropic medication in young people, and hopefully, science and research will continue to catch up with clinical reality.

One problem with children under two receiving these medications is that one cannot get the feedback that you get treating older children and adults. Babies have very limited language skills and cannot participate in guiding treatment decisions. Additionally, the effects of these medications on the development of the young body of a baby are not known, and I think it is rational to worry about the high possible vulnerability of infant tissues.

As much as I believe in using drugs off-label I believe that babies should not be given psychotropic medication. Further tests are needed, and behavioral modifications should be tried first.

LINKS
Still in a Crib, Yet Being Given Antipsychotics

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

WEIGHT GAIN IN KIDS TAKING PSYCHOTROPIC MEDICATIONS

May 20th, 2015

What to do about weight gain in kids on psychotropic medications seems to be one of the leading concerns of parents. Some antipsychotic medications and antidepressants cause weight gain.

36947848_xlFirst, I want to make clear that these medications in many instances are very helpful in treating children with mental health disorders. Weight gain does not occur in all young people who take them. In some cases, the medications are life-saving. As a parent, you have to weigh the benefits. Usually, the benefits outweigh the risks of side effects including weight gain.

Having treated thousands of children in my career, I know that gaining weight itself comes with its problems — self-esteem, social acceptance, and of course one’s physical health.

If your child has been prescribed a medication that is known to cause weight gain, here are some things you can do. The first is to consult with your pediatrician to establish what a healthy weight is for your child. Keep track of your child’s weight. If weight is being gained, then a common sense cutback in calorie consumption is necessary. Work with your child to create a healthy lifestyle of eating and exercise and try to limit calorie content of foods as much as possible. It has been my experience that high fat and sugar snacks are often the culprits for kids on medications. Help your child to cut down noshing, and only nosh on low-calorie foods and decrease overall intake of calories.
The best thing to do is to work with children to teach them better eating habits. Encourage them to be hands-on in the decisions about what they eat. Have them help you in the kitchen. Take them food shopping. More importantly, be an example. If you are eating junk food, of course, they will want it too. Make outings more about doing things rather than about going out to eat or going for ice cream.

In the end, when your child is on antidepressant or antipsychotic medications weight should be watched. There is no magic here and no magic mechanism. As parents, we have to watch what we and what our children eat. Parents need to set a good example and help their children make good choices.

Disclaimer
This blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

ANTIPSYCHOTIC MEDICATIONS AND THE DISORDERS THEY TREAT

April 10th, 2014

I want to address in my latest series the antipsychotic medications and the disorders they treat. Of all the drug classifications, antipsychotics sounds the scariest to parents. They assume that by prescribing them, the doctor is saying their child is psychotic. It is essential to understand that this class of drug – in spite of its name – has many uses and has helped countless children with different disorders. Unlike stimulants, which essentially treat one mental disorder – ADD – antipsychotics are used in the treatment of not only psychoses (disorders that include the loss of touch with reality), as their name implies, but for many behavioral problems in children and teens.

These drugs are called antipsychotics because upon their introduction into mainstream psychiatry they were used primarily for the psychoses. However as time has passed, this has been greatly overshadowed by their widespread use treating a myriad of other conditions. Unfortunately, the name has stuck and thus the immediate anxiety parents and teens experience when they are suggested. Many parents simply won’t give it to their children just because of the label. Until someone comes up with a more suitable name, parents need to be educated and reassured.

In my next few blogs I will address the disorders and the use of these drugs for treating Schizophrenia, Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), Stimulant-Resistant Attention Deficit Hyperactivity Disorder (ADHD), Tics (Tourette’s syndrome), Childhood Bipolar Disorder, and some other trends in the use of the antipsychotics.

DISCLAIMER

Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.