If you have been told that your child would benefit from taking medication, the following guide will help.

1. Have your doctor explain your child’s diagnosis in as much detail as possible. Is there a known cause for the difficulty? What course might the disorder take if not treated? For example, if a child with ADHD doesn’t get treatment, the chance of substance abuse increases as the teenage years approach. Teenagers not treated for depression have an increased suicide risk. What positive effects of the medication will the psychiatrist be looking for? How long should it take? What will he do if it doesn’t work? While there is no medication which totally cures everything, your child’s prescription should target specific symptoms.
2. Make sure your child gets other forms of treatment along with medication. What does your doctor recommend? Individual talk therapy? Special school interventions? Behavioral therapy? Family counseling? Be wary of the practitioner who simply gives you a pill and wishes you good luck.
3. Make sure your child is physically healthy. If not, then the prescribing psychiatrist needs to be familiar with any medical condition. To this end, the doctor should take a detailed medical history of your child. In addition, I like to see a report of a recent physical examination from the child’s pediatrician. I also suggest a routine blood screening including a complete blood count, a routine metabolic screening, and also a routine twelve lead electrocardiogram in most cases. The blood tests and EKG will not only give signs of present conditions but will serve as baseline readings. Some medications affect blood tests and the EKG, and if we don’t have a baseline it will be difficult to know if future abnormal readings are caused by a medication or were always present.
4. Have a clear understanding of the medication’s side effects. Most side effects are fleeting and mild and don’t interfere much in your child’s life in any way, but they can be specific depending on the medication. You should know what they are so you don’t get worried. Serious or long lasting side effects for the child and teenage psychotropic drugs are rare, but again, you should be told of the signs. If you read information from the internet, be careful about the websites you choose. Don’t jump to the conclusion that the information you find online is more accurate than your psychiatrist’s years of clinical prescribing experience.
5. Make sure your child’s doctor, or a covering professional, is available twenty-four hours a day, 365 days a year, for any concerns you have about your child. Anything less is unacceptable.
6. Understand why the great majority of psychotropic medications given to young people are prescribed off-label, which means they haven’t been specifically approved for use by children. You will want to ask your prescribing psychiatrist what his particular experience is with the medication as well as what studies have shown about its use in children and teenagers.
7. Find out from your doctor what time of the day and how to give your child the medication. With meals, all pills at once, full or empty stomach? Although, many pharmacies now include a written summary of various aspects of the drug, follow the prescriber’s recommendations over those of the pharmacy. Call the doctor if there is a difference.
8. Determine what the medication will cost. Are there ways to cut the cost? Your pharmacist is the best source for that information. Cost alone should never force a decision as to choice of medication. Sometimes insurance companies make it difficult to get medication. Be persistent and get help from your psychiatrist to be sure your child gets exactly what the doctor ordered: generic or brand, the correct quantity, and refills, if possible.
9. Ask if there is a difference between generic and brand name drugs. I have not seen much of a difference between their effectiveness. Generic is usually okay. Some patients demand brand name medications and I go along with it, but with the caveat that these will cost more money with little research showing a beneficial effect.
10. Tell your child’s doctor about any other medications, supplements, or home remedies your child is receiving to be sure there are no adverse interactions with the prescribed medication. Remember even natural remedies can cause interaction problems.
11. Never compare dosages in milligrams between medications; they all differ and cannot be compared because of potency differences in the manufacturing process. Thus one milligram of one medication might equal in efficacy ten milligrams of another. For example, I recently had to explain to a patient that the new medication I was giving was measured in one half to two milligrams dosages and was replacing one that measured about thirty milligrams. It was simply another compound whose potency was measured differently.
12. Be prepared for your child’s doctor to recommend more than one medication. This use of multiple medications has become more common, as it sometimes gives better results. There are, however, risks to this practice which your doctor will need to explain. Risks include medication interaction, increased side effects, as well as decreased compliance because of the difficulty some patients have with multiple prescriptions. Always find out why your doctor is prescribing multiple medications and ask specific questions about the benefits and risks of such prescribing.
13. Always trust yourself and all the knowledge you have about your child. No one knows your child better than you and thus your observations of side effects, therapeutic effects, and overall well-being are the most valuable. Don’t be intimidated. Call your psychiatrist with any concerns.

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.