Psychiatric Medication For Children And Adolescents: Part II - Types Of Medications
No. 29; Updated May 2012
Psychiatric medications can be an effective part of the treatment for psychiatric disorders of childhood and adolescence. In recent years there have been an increasing number of new and different psychiatric medications used with children and adolescents. Research studies are underway to establish more clearly which medications are most helpful for specific disorders and presenting problems. Clinical practice and experience, as well as research studies, help physicians determine which medications are most effective for a particular child. Before recommending any medication, the prescriber should conduct a comprehensive psychiatric diagnostic evaluation of the child or adolescent. Parents should be informed about known risks and/or Food and Drug Administration (FDA) warnings before a child starts any psychiatric medication as well as whether the medication is being prescribed on-label or off-label (whether the medication has been approved for children and adolescents for the condition for which it is being prescribed). When prescribed appropriately by an experienced psychiatrist (preferably a child and adolescent psychiatrist) and taken as directed, medication may reduce or eliminate troubling symptoms and improve daily functioning of children and adolescents with psychiatric disorders.
ADHD Medications: Stimulant and non-stimulant medications may be helpful as part of the treatment for attention deficit hyperactive disorder (ADHD). They come in several different forms, such as pills, patches, and liquid forms. Examples of stimulants include: Dextroamphetamine (Dexedrine, Adderal, Vyanse, Procentra) and Methylphenidate (Ritalin, Metadate, Concerta, Daytrana, Focalin). Non-stimulant medications include Atomoxetine (Strattera), Guanfacine (Tenex, Intuniv) and Clonidine (Kapvay).
Antidepressant Medications: Antidepressant medications may be helpful in the treatment of depression, school phobias, panic attacks, and other anxiety disorders, bedwetting, eating disorders, obsessive-compulsive disorder, posttraumatic stress disorder, and attention deficit hyperactive disorder. There are several types of antidepressant medications. Examples of serotonin reuptake inhibitors (SRI's) include: Fluoxetine (Prozac), Sertraline (Zoloft), Paroxetine (Paxil), Fluvoxamine (Luvox), Venlafaxine (Effexor), Desvenlafaxine (Pristiq), Citalopram (Celexa) and Escitalopram (Lexapro). Examples of serotonin norepinephrine reuptake inhibitors (SNRIs) include Venlafaxine (Effexor, Pristiq), and Duloxetine (Cymbalta). Examples of atypical antidepressants include: Bupropion (Wellbutrin), Nefazodone (Serzone), Trazodone (Desyrel), and Mirtazapine (Remeron). Examples of tricyclic antidepressants (TCA's) include: Amitriptyline (Elavil), Clomipramine (Anafranil), Imipramine (Tofranil), and Nortriptyline (Pamelor). Examples of monoamine oxidase inhibitors (MAOI's) include: Phenelzine (Nardil), and Tranylcypromine (Parnate).
Antipsychotic Medications: These medications can be helpful in controlling psychotic symptoms (delusions, hallucinations) or disorganized thinking. These medications may also help muscle twitches ("tics") or verbal outbursts as seen in Tourette's Syndrome. They are occasionally used to treat severe anxiety and may help in reducing very aggressive behavior. Examples of first generation antipsychotic medications include: Chlorpromazine (Thorazine), Thioridazine (Mellaril), Fluphenazine (Prolixin), Trifluoperazine (Stelazine), Thiothixene (Navane), and Haloperidol (Haldol). Second generation antipsychotic medications (also known as atypical or novel) include: Clozapine (Clozaril), Risperidone (Risperdal), Paliperidon (Invega), Quetiapine (Seroquel), Olanzapine (Zyprexa), Ziprasidone (Geodon) and Aripiprazole (Abilify) Iloperidone (Fanapt), Lurasidon (Latuda), and Asenapine (Saphris).
Mood Stabilizers and Anticonvulsant Medications: These medications may be helpful in treating bipolar disorder, severe mood symptoms and mood swings (manic and depressive), aggressive behavior and impulse control disorders. Examples include: Lithium (lithium carbonate, Eskalith), Valproic Acid (Depakote, Depakene), Carbamazepine (Tegretol), Lamotrigine (Lamictil), and Oxcarbazepine (Trileptal).
Anti-anxiety Medications: Selective serotonin reuptake inhibitors (SSRIs) are used to treat anxiety in children and adolescents and are described above in the antidepressant section. There are also other medications used to treat anxiety in adults. These medications are rarely used in children and adolescents, but may be helpful for brief treatment of severe anxiety. These include: benzodiazepines; antihistamines; and atypicals. Examples of benzodiazepines include: Alprazolam (Xanax), lorazepam (Ativan), Diazepam (Valium), and Clonazepam (Klonopin). Examples of antihistamines include: Diphenhydramine (Benadryl), and Hydroxyzine (Vistaril). Examples of atypical anti-anxiety medications include: Buspirone (BuSpar), and Zolpidem (Ambien).
Sleep Medications: A variety of medications may be used for a short period to help with sleep problems. Examples include: Trazodone (Desyrel), Zolpidem (Ambien), Zaleplon (Sonata), Eszopiclone (Lunesta), and Diphenhydramine (Benadryl).
Miscellaneous Medications: Other medications are also being used to treat a variety of symptoms. For example: clonidine (Catapres, Kapvay) and guanfacine (Tenex, Intuniv) may be used to treat the severe impulsiveness in some children with ADHD.
Many newer medications are taken once a day. These medications have the designation SR (sustained release), ER or XR (extended release), CR (controlled release) or LA (long-acting).