Psychotropic Medication for Children: A Doctor’s View

I have had concerns for years about the use of atypical antipsychotics in children and young adults. My feelings are based on my son Dan’s experiences with these medications, which wreaked havoc on him, physically and mentally. These drugs also exacerbated his OCD and left him with a slew of side effects. And Dan is certainly not the only one who has been negatively affected by these medications. The potentially dangerous side effects of these drugs have been well-documented.

Dr. Allen Frances, a world-renowned psychiatrist and professor emeritus at Duke University, wrote an important article in July 2015 for Psychiatric Times which begins with this sentence: “A perfect storm of interacting detrimental factors has resulted in the recent massive overuse of psychotropic medication in children.”

I highly recommend reading this easy-to-understand article, even though it is primarily written for psychiatrists. Dr. Frances makes excellent points and cites a checklist meant to help doctors evaluate whether or not a child should be prescribed these drugs. He says:

Doctors have swallowed the misleading sales pitch that typical problems in children are really underdiagnosed and undertreated “mental disorders” — very easy to diagnose and very easy to treat with a pill. Just the opposite is true. Children change so much in response to environment and development that their diagnosis and treatment always require the greatest care, patience, and time. I can’t picture ever starting a child on medications after a brief evaluation, but this is often done.

I have said many times before that I believe parents’ thoughts, feelings and opinions should always be considered and taken seriously when it comes to any kind of treatment for their children. Collaboration is important as nobody knows, cares, about, or loves their children more than they do. So it’s not surprising that the paragraph below is my favorite one of the article, and it is even more meaningful because it comes from such a well-respected doctor:

Parents far too readily follow doctors’ advice about medication for their children. I recommend always becoming a fully informed consumer and getting second and third opinions before allowing your child to take any psychiatric medicine. This is an important decision that requires careful deliberation and full parental input.

When talking about OCD and these drugs, it is important to realize that studies have shown atypical antipsychotics to be no more beneficial than a placebo for those already taking an SSRI. Exposure and response prevention (ERP) therapy, the psychological approach to treat OCD as recommended by the American Psychological Association, continues to be the gold standard for treating OCD. And it can be utilized in an age-appropriate manner for children as young as four or five years of age with no side effects.

Every child’s situation is unique and pros and cons of medication should be weighed carefully. However, if you are seriously considering using an atypical antipsychotic as part of your child’s treatment plan for OCD, please read Dr. Frances’s article. You might just change your mind.

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