Medications?

BIG DISCLAIMER: I am not a doctor, I don't pretend to be a doctor, and I am not giving medical advice here. I am giving my opinion as one parent to another about how I consider psychiatric medications and how they may or may not be used on my child. I don't advocate FOR or AGAINST medications. This is a highly personal decision, but since I have some knowledge of these types of medications due to the fact that in my former life(before children) I worked in a psychiatric hospital with patients who suffered from a number of severe mental health issues so gained a bit of understanding of different types of medications used for psychiatric disorders so I make somewhat informed decisions about my child's medications. I don't know a lot about specific medications and i don't intend to try to explain how drugs interact or work on different parts of the brain or anything like that. That is what doctors are for, but having a working knowledge of the kinds of medications that are used and what those classifications means helps me to make more informed decisions about my daughter's medications than a lot of other people are able to make. This is just me sharing about how I think when I hear a doctor talking about which medications to prescribe for my child, and I think it might help if you don't ahve this sort of knowledge.

I was talking to a mom today who was sharing about her daughter with autism and ADD/ADHD having been medicated in the past and that she believes she may want to try medications again. I am not an anti-medication person, I medicate my daughter and although I wouldn't be so rude or presumptive as to tell others they should medicate, I also wouldn't tell others not to. A lot goes into that sort of a decision. What this mom shared though, shocked me! Not because I would expect her to know about classifications of drugs and what different drugs are intended to do, but having some experience working with psychiatric patients I have some limited knowledge of some psych medications and it seemed that her daughter had been given medications for symptoms she just did not have.

In the psych med world there are basic types of medications. Anti-anxiety or tranquilizers which are used for anxiety (no duh right?). Then there are anti- depressants which are for what else, depression. Some of the anti depressant medications are also used for anxiety disorders and for Obsessive Compulsive Disorder. There are mood stabilizers which are mostly for people who have mood swings, usually with Bipolar disorder. There are medications that are intentionally designed to help with both anxiety and depression, because those two so often go hand in hand and they are sometimes used for people with Bipolar disorder too. Then there are the big guns, anti-psychotic medications. These are really strong medications intended for use for people who have a condition called psychosis. Psychosis is a condition that is characterized by the person not being in touch with reality. People with psychosis see things that aren't there, hear things that aren't there, have thought disorders like paranoia or even odd thinking, an example I heard recently about a young man who shared that his hair was growing back in on his head (I have no idea why it was gone in the first place but it was) and he said that the hair coming back on his head was itching his brain. That is a thought disorder, it doesn't make any sense in our world that we consider "normal". A client I worked with at one time believed he was the "Ambassador from Mars", this is another type of thought disorder. In addition to these drugs are the medications generally given for ADD/ADHD which most often are stimulants, but at least one is a non-stimulant, it is called Strattera. They also use some blood pressure medications for anxiety and ADD/ADHD, the newest being Intuniv, which is a long acting form of a blood pressure medication that is given in doses much lower than are used for patients with high blood pressure.

So, this woman was telling me that she had hoped to get back into her daughter's former psychiatrist, but he didn't have any openings. She told me that her daughter had been on Risperdal (an anti-psychotic) and Abilify (a mood stabilizer/anti-psychotic). I don't know this woman's daughter but we have spoken several times before and this surprised me. I asked if her daughter was aggressive in the past. She said no. Was she self-injurious? Did she have extreme melt-downs in which she could have harmed herself? Did she hear voices or anything like that? She said no. All she had felt she needed the medications for was her ADD/ADHD, and she shared that really her daughter wasn't especially hyperactive, maybe impulsive but not hyper. So why would the doctor have put her on such a strong medication? The other thing that struck me was that the medications hadn't helped with her daughter's ADD/ADHD so she had stopped medicating her thinking that medication wouldn't help her child. The only reason she is going back to visit that idea is that the RC suddenly terminated her daughter's ABA when the child was out of school for summer break, so she also had no ABA funded by the school district and she was seeing her daughter regress and have behaviors she hadn't seen for a long time. She doesn't want to see her daughter forced into a more severe classroom that she needs because her therapies were abruptly ended so she is feeling a bit desperate.

So I'm thinking, "Isn't God good? He kept this child from going back to a doctor who was giving her medications for conditions she doesn't have and not giving her medications for the condition she does have!" Then I got to thinking back to my early college psychology classes when we were taught that autism was supposed to be "childhood schizophrenia". We aren't completely sure about what autism is and what it isn't but we can be very sure that it isn't any kind of schizophrenia, it is completely different.

So, when a psychiatrist starts naming off medications for MY kid I want to know what kind of medication they are talking about. Are they talking about prescribing an anti-depressant, an anti-anxiety, an anti-psychotic medication, or are they talking about prescribing a stimulant or non-stimulant medication to help with ADD/ADHD symptoms? If I go in and tell the doctor my child is having sinus problems and they want to put a cast on her arm I know something is amiss. It's the same if I say my child seems to have or has been diagnosed with ADD/ADHD and they want to give her an anti-psychotic medication.

Autism is not a psychotic disorder. There are no medications that have been studied and found useful for autism - although there are medications that are used for different symptoms of autism. Now, kids with autism can have all types of psychiatric problems and many do, but we can't give them a pill and have the autism get all better. Many kids with autism also have ADD/ADHD. Another problem that is often concurrent with autism is anxiety. OCD (Obsessive-Compulsive disorder) is highly correlated, and kids with autism are more likely to get Tourette's Syndrome than in the typical crowd. So our kids may benefit from medications for some or many of these issues. Heck, we even fostered one beautiful child who had both autism and schizophrenia. This is very rare, but once she was given anti-psychotic medication she started sleeping because she didn't have the voices in her head keeping her awake all night. For her, anti-psychotic medication was beneficial, in fact it was nearly a miracle to watch her come out of her psychosis and begin to enjoy life, but then her father had been diagnosed with schizophrenia so she came by it genetically and she wasn't being medicated inappropriately. Occasionally kids who are very aggressive can benefit from anti-psychotic medication, even then I would want to try other medications first, medications that have less side effects and less possibility of long term effects. We need to know why a doctor is giving our children the medications they are suggesting. We need to know they aren't living in the dark ages of calling autism "childhood schizophrenia" and medicating for a condition that does not exist.

I always ask questions like what classification of medication is that? Why do you think that particular medication would be better than another for my child? What side effects should I look for? Which symptoms is that particular medication supposed to help with? The answers give me an idea of what the doctor is thinking. Are they thinking my child has an attention problem or do they think my child is not based in reality? I know which it is, do they? I also ask my pharmacist a lot of questions, but then I have a great pharmacist, not everyone is so lucky, but it's great if you can find one who will answer your questions and go over side effects with you.

I hope I'm not being too "preachy" here. I just had not realized how blessed I am to have the information I have and how unfortunate it is that some doctors will just make so many bad decisions for parents who aren't in the know. If you aren't sure about a medication that is prescribed for your child, ask the doctor about it, if they get defensive, find another doctor. Look on the internet and find out what kind of medication your child is prescribed, get to know what side effects to look for, if you don't get a list of them with the medication, go online and Google (or Bing or Ping or whatever) the name of the medication and side effects (i.e. Prozac side effects). Ask therapists since they are trained in medications even though they don't prescribe. Ask your child's other doctors, their pediatrician or immunologist if you are unsure about what to do. Get multiple intelligences going. Being nosy could be the very best thing when it comes to medications for our kids with autism.

Finally: If you are interested in looking at more information about medications I have included a medication gadget to your right. I'm sure I will add additional links as time permits but this are some of the best links I could find right off the bat.