The Controversary Over Pediatric Psychiatric Medication Usage - On Second Thought: from Iffy to Witty Thoughts
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The Controversary Over Pediatric Psychiatric Medication Usage

The Controversary Over Pediatric Psychiatric Medication Usage

In the year 2020, there was approximately 6 million children ages 0 to 17 taking psychiatric medications and with surge in behavioral health symptoms youth are experiencing as a result of the pandemic, that number is only going to increase.  There is concern however about the impact both short and long term on the safety of use of medications in children, making it difficult at times to know how best to proceed if your child is experiencing mental health symptoms.

Limited research into the pediatric use of psychiatric medications has occurred over the past several decades, due to numerous ethical and logistical reasons.  Dr. Ralph Kauffman, a pediatric medical researcher at Children’s Mercy Hospital in Missouri reports “Experience has shown us that we need to study drugs in children because they aren’t small adults…There are dynamics of growth and maturation of organs, changes in metabolism throughout infancy and childhood, changes in body proportion, and other developmental changes that affect how drugs are metabolized.” He goes on to say in an article reported by the FDA that there is increased research in the past 5 years, with more pediatric medication studies being conducted than in the prior three decades.

There is a lot of information available on the internet about the use of medications for young people struggling with symptoms of anxiety, depression, or other behavioral health symptoms.  Plenty describing the over use of medications such as stimulants for ADHD symptoms, but not all of the information is rooted in scientific data or fact.  Parents face a difficult decision for a child struggling with mental health symptoms, weighing out the pros and cons of using medications to assist the child in managing symptoms and sorting through the information available.  This article will outline some of the key facts in the controversary related to the use of pediatric psychiatric medications.

Some of the risks associated with the use of medications are the obvious concerns of risk of side effects, black box warnings of increased suicidal risks with anti-depressants, and the off-label use of adult medications not adequately studied in young people.  Additionally, there is the risk of stigma from peers and other parents who may learn a child is taking medications.  But despite some of these legitimate concerns, Max Wiznitzer, MD, a pediatric neurologist cites there is also a lot of misinformation that is not rooted in empirical data, such as the “over-prescription” of medications or that doctors financially benefit from prescribing medications. This misinformation may result in parents and guardians hesitating to seek out prescription medications to support their child.

When exploring the possible prescription of psychiatric medications for pediatric symptoms, here are some important factors to consider that may support the decision:

  • One study published in the Journal of Child Psychology and Psychiatry identifies that the use of medications to mitigate symptoms can help to improve functioning and performance for children in school and in their interpersonal interactions. The benefits of this can help promote improve self-esteem and limit some of the negative impacts of poor academic performance and behavioral issues in school.
  • Effectively treating symptoms helps to prevent them from worsening. Untreated psychiatric symptoms can lead to the use of drugs and alcohol to self-medicate, can continue to worsen causing sleep disturbance, and may result in life threatening thoughts of suicide.
  • Researchers are beginning to examine the impact of psychiatric medications on the brain, citing that these medications can help prevent negative changes in the brain resulting from the symptoms a person is experiencing.

While these positives support the use of medications for behavioral health symptoms, there remains caution on relying too heavily on pharmacological support.  Multimodal treatment is linked to improved overall outcomes, suggesting that relying on medications alone to support a child’s mental health is not an advantageous approach.  The National Institutes of Health reported on a study that found that the use of a psychiatric medication alone or the use of Cognitive Behavior Therapy (CBT) in children with severe anxiety were both effective, however those who received a combination of both medication with CBT showed 20 to 30% more improvement in their symptoms.

This evidence supports that seeking out both therapeutic resources combined with psychiatric medications can offer relief for children struggling with mental health symptoms.  Learning skills, changing unhealthy thought patterns, and learning behaviors that support wellness can never be accomplished solely through the use of a medication, however it can offer some relief so that the child can focus on learning these skills.  Parents should seek out the support of a mental health professional to help them to navigate the best options for their family and ensure safe, effective use of pharmacological supports.