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Psychiatric Medication
Part 2: Types of Medications

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 psychiatrist (preferably a child and adolescent psychiatrist) should conduct a comprehensive diagnostic evaluation of the child or adolescent. The youngster's presenting psychiatric symptoms along with past response to medications and also consideration of possible side effects will determine the choice of medication. Psychiatric medication should only be used as part of a comprehensive treatment plan.

Stimulant Medications: Stimulant medications are often useful as part of the treatment for attention deficit hyperactive disorder (ADHD). Examples include: Dextroamphet-amine (Dexedrine, Adderal), Methylphenidate (Ritalin), and Pemoline (Cylert).

Antidepressant Medications: Antidepressant medications are used in the treatment of depression, school phobias, panic attacks, and other anxiety disorders, bedwetting, eating disorders, obsessive-compulsive disorder, personality disorders, posttraumatic stress disorder, and attention deficit hyperactive disorder. There are several types of antidepressant medications (tricyclics, serotonin reuptake inhibitors, monoamine oxidase inhibitors and atypical). Examples of tricyclic antidepressants (TCA's) include: Amitriptyline (Elavil), Clomipramine (Anafranil), Imipramine (Tofranil), and Nortriptyline (Pamelor). Examples of serotonin reuptake inhibitors (SRI's) include: Fluoxetine (Prozac), Sertraline (Zoloft), Paroxetine (Paxil), Fluvoxamine (Luvox), Venlafaxine (Effexor), and Citalopram (Celexa). Examples of monoamine oxidase inhibitors (MAOI's) include: Phenelzine (Nardil), and Tranylcypromine (Parnate). Examples of atypical antidepressants include: Bupropion (Wellbutrin), Nefazodone (Serzone), Trazodone (Desyrel), and Mirtazapine (Remeron).

Antipsychotic Medications: Antipsychotic 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 traditional antipsychotic medications include: Chlorpromazine (Thorazine), Thioridazine (Mellaril), Fluphenazine (Prolixin), Trifluoperazine (Stelazine), Thiothixene (Navane), and Haloperidol (Haldol). Newer antipsychotic medications (also known as atypical or novel) include: Clozapine (Clozaril), Risperidone (Risperdal), Quetiapine (Seroquel), Olanzapine (Zyprexa), and Ziprasidone (Zeldox).

Mood Stabilizers and Anticonvulsant Medications: Mood stabilizers may be helpful in treating manic-depressive episodes, excessive mood swings, aggressive behavior, impulse control disorders and severe mood symptoms in schizoaffective disorder and schizophrenia. Lithium (lithium carbonate, Eskalith) is an example of a mood stabilizer. Some anticonvulsant medications can also help control severe mood changes. Examples include: Valproic Acid (Depakote, Depakene), Carbamazepine (Tegretol), Gabapentin (Neurontin), and Lamotrigine (Lamictil).

Anti-anxiety Medications: Anti-anxiety medications may be helpful in the treatment of severe anxiety. There are several types of anti-anxiety medications: benzodiazepines; antihistamines; and atypicals. Examples of benzodiazepines include: Alprazolam (Xanax), lorazepam (Ativan), Diazepam (Valium),and Clonazepam (Klonopin). Examples of antihistamines include: Diphenhydramine (Benadryl), and Hydroxizine (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: SRI anti-depressants, Trazodone (Desyrel), Zolpidem (Ambien), and Diphenhydramine (Benadryl).

Miscellaneous Medications: Other medications are also being used to treat a variety of symptoms. For example: clonidine (Catapres) may be used to treat the severe impulsiveness in some children with ADHD and guanfacine (Tenex) for "flashbacks" in children with PTSD.

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.

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Medication, Part 3 would like to thank American Academy of Child and Adolescent Psychiatry for this information in striving to make daycare and childcare a more productive and efficient service. You can contact them at: 3615 Wisconsin Ave., N.W., Washington, D.C. 20016-3007 voice: 202-966-7300 fax: 202-966-2891.

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