By: Sarah Grayce, MD
The decision to start your child on psychiatric medication is important and not always easy. It is normal to have questions and concerns about how this decision might affect your child. As information about medication becomes more accessible to the general population, there are also more and more myths circulating about medication as well. Here are some of the most common questions and concerns that I discuss with my clients on a daily basis:
Question:Will medication change my child’s personality?
Answer:This is a very common concern that parents have about starting their child on a psychiatric medication. The short answer is no. The right medication for your child is a tool that can help them be the best versions of themselves. The goal with medication is to reduce your child’s distressing symptoms without changing their personality that you know and love. If your child is taking a medication and you are worried they seem different or unlike themselves, those concerns should be shared with your prescriber.
Question:Will my child have to be on medication forever?
Answer: In most cases, once medication has been effective for a period of time your child’s medication can be slowly tapered and then stopped. We usually recommend that once your child is taking a medication that is helping their symptoms, that medication should be continued for about a year. After that you and your prescriber should talk about whether it would be a good time to stop medication. In many cases treatment for this amount of time effectively treats symptoms and can prevent symptoms from coming back, especially if your child is also participating in therapy. In some cases kids do need to take medication for longer periods of time or restart medication later in life. Your prescriber will work with you to make the best plan for your child’s individual needs.
Question:Can my child become addicted to medication?
Answer:When taken as prescribed, your child should not become addicted to psychiatric medication. There is no known risk of addiction or dependence on antidepressants. There are certain kinds of psychiatric medications that people do abuse (including stimulants and certain types of anxiety medication). Stimulant medications (which are commonly used to tread ADHD) can actually reduce the risk of substance abuse later in life when prescribed for ADHD and taken appropriately – we think this has to do with reducing impulsive and risky behavior. Certain types of anxiety medications can be habit forming, and these are occasionally used in children in special situations, however the risk of addiction remains low when they are taken as prescribed.
Question:I heard that antidepressants can cause suicidal thoughts. Is this true?
Answer: This is extremely unlikely. There is a FDA black box warning on all antidepressants for kids and young adults (up to age 24) that these medications may increase their risk of suicidal thoughts. This warning came from a study done by the FDA where they found that about 4% of kids taking antidepressants in research studies reported suicidal thoughts, vs. 2% of the kids not taking antidepressants (taking placebo drugs). There was no difference in suicidal behaviors between the groups. Since then, there has been data that has conflicted with this study and has caused us to question the accuracy of this warning. The bottom line is that the risk of suicidal thoughts due to untreated depression and anxiety is much higher than any possible risk of suicidal thoughts related to medication.
Question:Where should I go to find more information about my child’s medication?
Answer:Always feel free to ask your prescriber if you have questions or concerns about your child’s medication. If you are interested in doing more research, the following websites are good, evidence-based resources to find more information:
National Alliance on Mental Illness https://www.nami.org/
American Academy of Child & Adolescent Psychiatry https://www.aacap.org/AACAP/Families_and_Youth/Family_Resources/Home.aspx
Child Mind Institute https://childmind.org/