A growing number of children suffering from emotional or behavioral issues are receiving multiple medications, which is called polypharmacy. This guide will help parents make informed decisions about their child's medication, particularly when there are multiple being taken at once.
Combining medications can work well when prescribed and monitored by a specialist with training and experience with child psychiatry. However, parents should be aware of the potential side-effects associated with adding medication to their child's regimen and the accompanying signs to watch for.
Why give your child more than one medication?
These are the most common reasons a doctor may recommend adding medication.
Some children take multiple medications because they have more than one disorder. It's not uncommon for a child with a chronic condition to take multiple medications. For example, ADHD, anxiety, and depression can occur at the same time, which is called comorbidity. All of these conditions can be helped with the correct medications.
Your healthcare provider may recommend adding another prescription to increase the effectiveness of a medication that isn't currently working as well as it could. If your child has ADHD and has not improved on stimulant medication, your doctor may suggest adding a non-stimulant drug to provide further help with ADHD symptoms.
Your provider may be able to reduce the dosage of medication that is effective but causes side effects. To treat any remaining symptoms, they may add another medication. Your psychiatry provider may prescribe a non-stimulant to your child if they are unable to tolerate a high dose of stimulant medication.
Sometimes, medications can be added to the original prescription to reduce side effects without having to lower the dosage. If your child has a medical condition such as diabetes, you may need to include additional medications. Or if you have trouble sleeping such as insomnia, your doctor may prescribe medication to treat it as well as your mental health medication.
Is it safe for kids to take more than one medication?
Children's treatment is different from adults, so it takes special care and considerations to provide medication management for them. This is largely because their brain and nervous system is still developing, so they have a need for consistent supervision and monitoring of their medications as they grow.
When considering multiple medications for children, caution and a “less is more” approach is often advised, where a new medication is only introduced if necessary.
Adding medications to a child's treatment plan should not be done instead of behavioral therapies that have been proven to work for children for issues such as ADHD, anxiety, depression, and disruptive behavior. In these cases, behavioral therapy is often suggested as a first line of treatment with medication as a possible combination treatment.
Are There Any Signs That Your Child is Taking Too Many or Too Few Medications?
It can be difficult to find the right dosage and medication for children, just like adults. The ideal dosage varies a lot among both children and drugs. When starting a new medication, a good rule of thumb for kids is "start low, go slow."
A partial improvement in a child's health could indicate that the medication is a good option, but that a higher dose may be necessary. Signs that a medication dosage is too high include:
Changes in appetite and sleep patterns (in both directions)
Signs of confusion and differences in thinking patterns
Anything that is not normal for the child's age
Allergy symptoms such as a rash, digestive disturbance, and dangerous side effects (such as suicide attempts, which have been linked to certain psychotropic drugs) should be taken very seriously and reported to your psychiatric provider immediately.
4 Tips for How to Add a New Medication to Your Child’s Regimen
It is not a good idea for a child to start taking multiple medications all at once. You and your psychiatry provider should only give your child one medication at a time. This will allow you to monitor side effects and measure how they affect your child's mood and behavior.
When your child's routine and life are stable, you should add new medications and make dosage changes. Avoid times such as the beginning of a new school year or vacation, moving to a new place, or when your child is sick.
It's important that you inform everyone involved in your child's care, including teachers and caregivers, when you are changing or adding medication.
It is important to consider other changes in the lives of your child at home and school, as well as any potential effects on her emotions and behavior. Do not assume that the medication is responsible for any changes.