Psychiatric Medication For Children And Adolescents: Part II - Types Of Medications
No. 29; Updated July 2017
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. Child and adolescent psychiatrists and other clinicians use information from research, clinical practice and experience, and information about the individual child to determine which medications will be the most effective for a particular child. Before recommending any medication, the prescriber should conduct a comprehensive psychiatric assessment.
Before starting a medication, the clinician prescribing the medication should discuss the following with parents:
- Results of the assessment (your child's diagnosis)
- Target symptoms
- Risks of the illness if untreated
- Potential benefits of the medication
- Known risks, side effects, and/or Food and Drug Administration (FDA) warnings
- 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 clinician 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, Adderall, Vyvanse, Procentra), Methylphenidate (Concerta, Daytrana, Metadate, Ritalin), and Dexmethylphenidate (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 selective serotonin reuptake inhibitors (SSRIs) include: Fluoxetine (Prozac), Sertraline (Zoloft), Paroxetine (Paxil), Fluvoxamine (Luvox), Citalopram (Celexa), and Escitalopram (Lexapro). Examples of serotonin norepinephrine reuptake inhibitors (SNRIs) include Venlafaxine (Effexor), Desvenlafaxine (Pristiq), and Duloxetine (Cymbalta). Examples of atypical antidepressants include Bupropion (Wellbutrin), Nefazodone (Serzone), Trazodone (Desyrel), and Mirtazapine (Remeron). Examples of tricyclic antidepressants (TCAs) include Amitriptyline (Elavil), Clomipramine (Anafranil), Imipramine (Tofranil), and Nortriptyline (Pamelor). Examples of monoamine oxidase inhibitors (MAOIs) include Phenelzine (Nardil) and Tranylcypromine (Parnate).
Antipsychotic Medications: These medications can be helpful in controlling psychotic symptoms (delusions, hallucinations) or disorganized thinking. They are also used to treat irritability in autism. These medications may also help muscle twitches ("tics") or verbal outbursts as seen in Tourette's disorder. 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 Aripiprazole (Abilify), Clozapine (Clozaril), Risperidone (Risperdal), Olanzapine (Zyprexa), Paliperidone (Invega), Quetiapine (Seroquel), Ziprasidone (Geodon), Iloperidone (Fanapt), Lurasidone (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, Lithobid), Valproic Acid (Depakote, Depakene), Carbamazepine (Tegretol), Lamotrigine (Lamictall), 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 atypical antipsychotics. 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 melatonin, Trazodone (Desyrel), Zolpidem (Ambien), Zaleplon (Sonata), Eszopiclone (Lunesta), and Diphenhydramine (Benadryl).
Long-Acting Medications: 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).