Overview of Psychiatric Medications in Children and Adolescents - II
Class: MAOIs (monoamine oxidase inhibitors)
Benefits: Used to treat treatment-resistant depression and anxiety. Side Effects: Dizziness, sedation gastrointestinal symptoms, low blood pressure, changes in appetite and weight.
These medications are rarely used in children and adolescents. Tyramine, an amino acid in some foods can interact with these medications to trigger severe high blood pressure. People taking them must follow a restricted diet (Emsam at lower doses does not require the diet).
Class: Antipsychotics (sometimes called Neuroleptics)
Benefits: Treats psychosis, schizophrenia, bipolar disorder and aggression. Orap and Haldol are used to treat Tourette Disorder. Has been used to treat behavioral symptoms of Autism. Side Effects: Dizziness, sedation, dry mouth, constipation, blurred vision, increased appetite, restlessness, muscle stiffness. Prolonged use may result in a movement disorder called tardive dyskinesia.
With the introduction of newer antipsychotics these medications are used much less frequently.
This is only a partial list of the medications in this class.
Class: Second generation (atypical) antipsychotics
Benefits: Treats psychotic conditions such as schizophrenia can be useful in helping stabilize mood in bipolar disorder and in impulsive/aggressive behavior. Side Effects: Weight gain, sedation, dizziness, insulin resistance, muscle stiffness.
Has been studied in the treatment of aggression and irritability in Autism and recently received FDA-approval for children and teens (age 6 and up) with autism and behavioral problems
May be the most effective medication in treatment resistant psychotic conditions. Must get weekly blood tests to monitor for a rare side effect that can depress the formation of blood cells.
Class: Anxiolytic (benzodiazepines)
Benefits: Reduces panic, anxiety symptoms. Generally used for short- term treatment. Side Effects: Sedation, dizziness.
Xanax Xanax XR
Can cause paradoxical hyper-excitability especially in young children. Is occasionally used for the treatment of mania. Often works immediately.
Benefits: Used for the treatment of general anxiety symptoms—not helpful for separation anxiety or social phobia Side Effects: Dizziness, nausea, sedation.
Often takes several weeks to work.
Class: Hypnotics (sleep)
Benefits: Enhances sleep onset and quality of sleep. Side Effects: Dizziness, can cause paradoxical hyperexcitability especially in young children.
Ambien Ambien CR
These medications are generally not used as a first line treatment of insomnia. Understanding and dealing with the underlying issues that are disrupting sleep is always the first step.
Class: Mood Stabilizers
Benefits: Treats the symptoms of bipolar disorder. Side Effects: Excessive thirst, frequent urination gastrointestinal symptoms, acne, weight gain.
Lithium Lithobid Eskalith
Requires frequent monitoring of lithium blood level, thyroid and kidney functioning. Excessive doses are dangerous. The most established and well studied medication for bipolar disorder.
Class: Anti-Convulsants (anti-seizure)
Benefits: This group of medications has been used in the treatment of bipolar disorder and aggressive behavior. Side Effects: Sedation, tremor, gastrointestinal distress, weight gain.
Well studied in the treatment of bipolar disorder. Has been used as a treatment of migraines. Requires occasional lab tests. May cause polycystic ovary disease.
Well studied in the treatment of bipolar disorder. Requires occasional lab tests.
A newer version of carbamazepine.
Appears to be very helpful in treating the depressive phase of bipolar disorder but is not clearly helpful in the manic phase. Very rarely, can trigger a life-threatening rash.
The utility of the following medications in bipolar disorder is still under investigation.