Medications that are used for childhood mental disorders?
There are several major categories of psychotropic medications:
stimulants, antidepressants, antianxiety agents, antipsychotics, and mood
stabilizers. For medications approved by FDA for use in children, dosages
depend on body weight and age.
Stimulant Medications: There are four stimulant medications that
are approved for use in the treatment of attention deficit hyperactivity
disorder (ADHD), the most common behavioral disorder of childhood. These
medications have all been extensively studied and are specifically labeled
for pediatric use. Children with ADHD exhibit such symptoms as short
attention span, excessive activity, and impulsivity that cause substantial
impairment in functioning. Stimulant medication should be prescribed only
after a careful evaluation to establish the diagnosis of ADHD and to rule
out other disorders or conditions. Medication treatment should be
administered and monitored in the context of the overall needs of the
child and family, and consideration should be given to combining it with
behavioral therapy. If the child is of school age, collaboration with
teachers is essential.
Antidepressant and Antianxiety Medications: These medications
follow the stimulant medications in prevalence among children and
adolescents. They are used for depression, a disorder recognized only in
the last twenty years as a problem for children, and for anxiety
disorders, including obsessive-compulsive disorder (OCD). The medications
most widely prescribed for these disorders are the selective serotonin
reuptake inhibitors (SSRIs).
In the human brain, there are many "neurotransmitters" that
affect the way we think, feel, and act. Three of these neurotransmitters
that antidepressants influence are serotonin, dopamine, and
norepinephrine. SSRIs affect mainly serotonin and have been found to be
effective in treating depression and anxiety without as many side effects
as some older antidepressants. The table shows the most commonly
prescribed medications for children with depression or anxiety disorders
(including OCD).
Antipsychotic Medications: These medications are used to treat
children with schizophrenia, bipolar disorder, autism, Tourette's
syndrome, and severe conduct disorders. Some of the older antipsychotic
medications have specific indications and dose guidelines for children.
Some of the newer "atypical" antipsychotics, which have fewer
side effects, are also being used for children. Such use requires close
monitoring for side effects.
Mood Stabilizing Medications: These medications are used to
treat bipolar disorder (manic-depressive illness). However, because there
is very limited data on the safety and efficacy of most mood stabilizers
in youth, treatment of children and adolescents is based mainly on
experience with adults. The most typically used mood stabilizers are
lithium and valproate (Depakote®), which are often very effective for
controlling mania and preventing recurrences of manic and depressive
episodes in adults. Research on the effectiveness of these and other
medications in children and adolescents with bipolar disorder is ongoing.
In addition, studies are investigating various forms of psychotherapy,
including cognitive-behavioral therapy, to complement medication treatment
for this illness in young people.
Effective treatment depends on appropriate diagnosis of bipolar
disorder in children and adolescents. There is some evidence that using
antidepressant medication to treat depression in a person who has bipolar
disorder may induce manic symptoms if it is taken without a mood
stabilizer. In addition, using stimulant medications to treat co-occurring
ADHD or ADHD-like symptoms in a child with bipolar disorder may worsen
manic symptoms. While it can be hard to determine which young patients
will become manic, there is a greater likelihood among children and
adolescents who have a family history of bipolar disorder. If manic
symptoms develop or markedly worsen during antidepressant or stimulant
use, a physician should be consulted immediately, and diagnosis and
treatment for bipolar disorder should be considered.
Information
provided by the National Institute of Mental Health