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Monthly NewsNote
September 2005
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How Long Will My Child Need To Take Medication?
When I start a child or teenager on medication I am commonly asked, “How
long will my child need to take it?” I think the question represents more
than the words themselves and needs to be answered at both the psychological level
as well as by giving a time frame. Because the question does need to be answered,
this Monthly NewsNote will discuss the subject of “how long.”
Putting their child on medication is often a cause of great concern to parents
because, among other things, it means their child is not well. In addition,
they have heard of the many problems related to medication such as Vioxx causing
stroke or the Canadian government withdrawing AdderalXR because they thought
it was dangerous. They have also heard that drugs like Prozac can be bad for
children and even make them want to commit suicide. Whether what they have heard
be truth or half-truth, they do influence a parent’s thoughts.
There are other factors that can cause concern. The internet, for example.
A parent may learn from the internet that Risperdol is for psychoses even though
I may have prescribed it for a different reason. They then might come to the
conclusion that my prescribing that medication means their child is “crazy”
which is, of course, very upsetting. When a male child has ADD I often have
the father objecting to the use of medication. They say, “He’s a
normal boy just like I was as a kid.” Therefore, medication means that
his child (and perhaps himself) is damaged, which he can’t handle.
The above paragraphs describe some of the causes of anxiety in the use of medication
that make a parent want to know “how long.” As part of the answer
I think it's important for the professional to understand and address the anxiety
issues. For parents, putting a voice to your fears and getting the right answers
are good first steps. I've found that as parents feel more comfortable with
the child's medication the question of "how long" often becomes less
important.
But let's address the question of "how long." Usually it is hard
to be precise. Sometimes I don’t know. If it is an ADD medication I use
the school year as a frame of reference. That is, a child started on medication
will need it through the school year. I then make sure the parents know we will
review the situation at that time to make further plans. If it is an antidepressant
we know the patient will need to be on the medication from six to twelve months.
For other medications I can talk in terms of relief of symptoms. That is, I
might say he may need the medication until he stops worrying so much about germs.
I give as much information as I can so the parents are always in the loop.
In summary, the parents' question needs to be addressed at two levels. One
relates to their anxiety and feelings about having a child on medication. The
other is the practical answer to the question. Both should be considered and
responded to when asked “how long.”
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