Medication is a treatment option for youth with certain brain-based mental health disorders. For some conditions, such as Attention Deficit Hyperactivity Disorder and Bipolar Disorders, medicine is often part of the initial treatment plan. For others, medication is considered if other treatments have been ineffective. Pacific Clinics is committed to the following ten principles in the use of medication.
- The psychiatrist partners with the youth, family and other professionals in a youth- and family-centered, team process. The doctor treats the youth and family as whole individuals, listens to their concerns, respects their wisdom and preferences and applies his/her own expertise to make recommendations about treatment options, including medication.
- Medicine is prescribed by a child and adolescent psychiatrist (a physician specializing in the mental health disorders of young people) only after a thorough psychiatric evaluation. At a minimum, this includes interviewing the youth, caregiver and clinician, as well as reviewing available records.
- Medication is never the only treatment but one element of a total treatment plan. Depending on the situation, a youth may participate in individual, group or family therapy, skills training and behavioral interventions, activities to build social support, special educational services, etc.
- Informed consent from the legal caregiver is required before psychotropic medication is prescribed. While minors cannot give “consent” in the legal sense, their “informed assent” is essential, especially for teenagers, who are educated about the purpose of medication, advised about possible side effects and encouraged to participate in treatment decisions.
- The purpose of medication is to reduce symptoms that interfere with well-being or ability to function in the family, school or community. Except for short term use in emergency situations, medication should never be prescribed for the purpose of slowing or sedating youth. By reducing symptoms such as impulsiveness, suicidal urges and hallucinations, properly prescribed medication gives a youth more, not less, control over their own behavior.
- Off-label prescribing (the use of medication not approved by the Federal Drug Administration as safe and effective for a certain condition or age group) is an accepted practice throughout the field of medicine. It is recommended by the psychiatrist only after careful consideration of medical research, clinical experience, alternative interventions and known and unknown risks.
- The psychiatrist meets with the youth and caregiver on a regular basis. The doctor actively manages medication to make sure that symptoms are being adequately reduced using the fewest number of medications at the lowest effective doses.
- Regular appointments are also necessary to monitor for any side effects. Vital signs are checked regularly and some medications require regular blood tests. In most situations, side effects do not occur at all or are mild. As a rule, persistent side effects that interfere with functioning (such as sleepiness) or pose a threat to health (such as elevated blood sugar or rapid weight gain) warrant a change in dose or type of medication.
- Medications should be prescribed for no longer than necessary, though this can be complicated. Like many medications (an example is for high blood pressure), psychotropic medicines can keep symptoms in check but do not “cure” disorders, so they are often needed for months or even years. The psychiatrist considers multiple factors in recommending just when and how a medication should be lowered or discontinued.
- Youth, caregivers and advocates are encouraged to discuss any concerns about medication with the psychiatrist. If necessary, Pacific Clinics staff will assist them in getting their concerns addressed.
