Considering Medication For Your Teen

Some physicians and mental health professionals view medications as the best or only solution to mental health problems. Others believe that medications should never be used. Neither extreme is helpful. Usually, the best team to decide if medication is appropriate is made up of the following individuals:

• A well-informed parent, or parents
• The teen’s psychotherapist, who should know the teen better than anyone except the parent
• A prescribing psychiatrist, or in some cases a family physician who is well informed about the medication under consideration. The psychiatrist or family physician should be comfortable working with both the psychotherapist and the family to arrive at the most informed decision, rather than making decisions alone
• And the teen him or herself, whose belief in the need for and the efficacy of the medication is an important factor in its effectiveness. It is also occasionally true that a teen may not want, but nevertheless clearly need, medication, in which case the other decision makers must overrule the teen's wishes.

• When the teen’s condition is so unstable that psychotherapy cannot be accomplished without the help of medication
• When the teen’s condition makes him or her dangerous to himself, herself, or others
• When psychotic episodes consistently block reality
• When your prescribing physician, psychiatrist, or other mental health professional advises of the necessity of medications

When medications are determined to be necessary, it is helpful to think of them as a temporary aid, like a cast for a broken arm, even while we know that a small percentage of individuals will in fact need to take medications for a long time, possible all their lives.

Reasons one might not want to take medications:

• If the side effects of the medication are potentially worse than the problem it is designed to resolve
• If the condition is not debilitating and psychotherapy has not yet been tried 
• Taking medications when not absolutely necessary may encourage the teen’s belief that he or she cannot, even with appropriate help, think through and resolve emotional issues that occur in life

Except in extreme cases, the middle road is usually the best: that is to say, utilize psychotherapy first, adding medication later if determined to be necessary, then continuing with the combination of therapy and medication until such time as it is deemed safe to reduce and eventually discontinue the medication.

Other things to keep in mind when considering the use of medications: 

• Always inform your prescribing physician of every medication you are taking, including non-prescribed supplements. Some combinations can be lethal
• Two to twelve weeks are commonly required for the full benefit of medication to be experienced
• Medications will usually decrease symptoms, but will seldom eliminate them entirely
• Medications should never be started, stopped, or changed without consulting your physician and therapist, who should work together for your teen’s benefit
• Medication usage and potential side effects should always be carefully monitored by the prescribing physician. Weekly follow-up is recommended at least during the first month of taking a new medication
• Any unusual behavior, such as the following, should be reported immediately to your prescribing physician:
• Increased agitation
• Increased irritability
• Comments about self-harm, or harming others
• Comments or behaviors that indicate suicidal thoughts, such as life not being worth living, giving away important possessions, and the like

Resources that provide information on specific medications:

Medline Plus U.S. National Library of Medicine
www.medlineplus.gov

National Alliance on Mental Illness
http://www.nami.org/

Physicians Desk Reference (PDR), or PDR for Mental Health Professionals, Thompson Medical Economics. Montvale, NJ
Available  through Amazon.com