Your Child and Medication

One in ten of America's children has an emotional disturbance such as attention deficit hyperactivity disorder, depression or anxiety, that can cause unhappiness for the child and problems at home, at play, and at school. Many of these children will be taken by their parents to their family physician or pediatrician, or, in many cases, a specialist in child mental health. The child will be carefully evaluated and may begin some type of therapy. There are many treatment options available. Choosing the right treatment for your child is very important. Each child is different. At times, psychotherapies, behavioral strategies, and family support may be very effective. In some cases, medications are needed to help the child become more able to cope with everyday activities.

If you are planning to have a doctor see your child, you should share a record of any of your child's medical problems, any medications your child is taking, including over-the-counter medications or vitamin and herbal supplements, and any allergic reactions your child has suffered. If a medication is prescribed for your child, there are certain questions you should ask. It will be helpful to take notes as it is easy to forget exactly what the doctor says.

• What is the name of the medication and how will it help my child?
• Is the medicine available in both brand-name and generic versions, and is it all right to use the less expensive (generic) medication?
• What is the name of the generic version? Is it all right to switch among brands, or between brand-name and generic forms?
• What is the proper dosage for my child? Is the dose likely to change as he or she grows?
• What if my child has a problem with the pill or capsule? Is it available in a chewable tablet or liquid form?
• How many times a day must the medicine be given? Should it be taken with meals, or on an empty stomach?
• Should the school give the medication during the day?
• How long must my child take this medication? If it is discontinued, should it be done all at once or slowly?
• Will my child be monitored while on this medication and, if so, by whom?
• Should my child have any laboratory tests before taking this medication?
• Will it be necessary to have blood levels checked or have other laboratory tests during the time my child is taking this medication?
• Should my child avoid certain foods, other medications, or activities while using this medication?
• Are there possible side effects?
• If I notice a side effect—such as unusual sleepiness, agitation, fatigue, hand tremors—should I notify the doctor at once?
• What if my child misses a dose? Spits it up?
• How well established and accepted is the use of this medication in children or adolescents?

You may think of other questions. Don't be afraid to ask. When you have the prescription filled, be sure the pharmacist gives you a flyer describing the medication, how it should be taken, and any possible side effects it may have. The label on the medication will have lots of information. Read the label carefully before giving the medication to your child. The label will give the name of the pharmacy, its telephone number, the name of the medication, the dosage, and when it should be taken. It will also tell you how many times the medication can be refilled.

If you want to learn more about your child's medication, you will find helpful books at your public library, or the reference librarian can show you how to look up the medication in the Physicians' Desk Reference (PDR). While a great deal of information about mental disorders and their treatment in children is available on the Internet, care is required to distinguish fact from opinion.

What Does "Off-label" Mean?

Based on clinical experience and medication knowledge, a physician may prescribe to young children a medication that has been approved by the U.S. Food and Drug Administration (FDA) for use in adults or older children. This use of the medication is called "off-label." Most medications prescribed for child mental disorders, including many of the newer medications that are proving helpful, are prescribed off-label because only a few of them have been systematically studied for safety and efficacy in children. Medications that have not undergone such testing are dispensed with the statement that "safety and efficacy have not been established in pediatric patients." The FDA has been urging that products be appropriately studied in children and has offered incentives to drug manufacturers to carry out such testing. The National Institutes of Health and the FDA are examining the issue of medication research in children and are developing new research approaches.

Help Your Child Take Medication Safely

Be sure the doctor knows all medications—including over-the-counter medications and herbal and vitamin supplements—that your child takes.

Read the label before opening the bottle. Make sure you are giving the proper dosage. If the medication is liquid, use a special measure—a cup, a teaspoon, a medicine dropper, or a syringe. Often a measure comes with the medicine. If not, ask your pharmacist which measure is most suitable to use with the medication your child is taking.

Always use child-resistant caps and store all medications in a safe place.

Never decide to increase or decrease the dosage or stop the medication without consulting the doctor. Don't give medication prescribed for one child to another child, even if it appears to be the same problem. Keep a chart and mark it each time the child takes the medication. It is easy to forget.

Resources

A Guide to Children's Medications. American Academy of Pediatrics.
Web site: http://www.aap.org/family/medications.htm

Facts for Families, a series of fact sheets that include information on medications for children, health insurance, how to seek help, and other topics. American Academy of Child and Adolescent Psychiatry.
Web site: http://www.aacap.org/cs/root/facts_for_families/facts_for_families

How to Give Medicine to Children. Food and Drug Administration.
Web site: http://www.fda.gov/fdac/features/196_kid.html