As holiday and summer breaks approach many parents take this time to give their children a medication holiday or use this time to adjust or try new medications.
Please speak to your prescribing physician before making any changes and weigh the pro’s and con’s. If a medication is not working then clearly a plan for change is needed but if your child is stable remember there is always a risk that once a medication is discontinued it may not have the same affect once restarted.
Making the decision to try medications for your child can be an overwhelming process. As much as you want answers and as much as you want to help your struggling child, take a breath, do not expect, or more importantly “accept” quick diagnosis or treatment. Give the doctor enough time to truly get a full picture of the difficulties knowing this cannot always be obtained in a short twenty minute evaluation.
I wish you all strength and calm and know how difficult this can be.
Let me start by saying I am not a doctor or a medical professional – I am a mom – a mom who has been there.
The decision to medicate your child is a very personal and heart wrenching one for many parents.
Whether the child has a mental illness or a physical one the stress and anxiety is the same.
The difference is in the stigma. Would you give your child insulin if diabetic, chemo for cancer, anticonvulsants for epilepsy?
Of course you would. What many people do not understand is that mental illness can be fatal. It can be severe and debilitating.
Does your child have a physical illness that requires medication? Do you lay awake at night worrying about the side effects?
Medicating a child is tough. It is draining and takes an informed, observant and stable parent to monitor.
First thing any parent should do is google a drug interaction checker and bookmark it.
Second thing any parent should do – buy a journal – journal every day several times a day if needed
Write down the medication – generic or brand – dosage – dates increased or decreased – reactions and side effects
You are your childs medical historian – be accurate and be consistant – it is amazing what we forget under stress
With possible medication trial and errors it is important to have a record for yourself and the doctor
Do your homework – when discussing medications with your childs doctor ask about all possible side effects
Discuss titrating and weaning. Discuss test dosing. Discuss doctors availability in event of a problem
Discuss blood work prior and during medication use – discuss heart or other pre-required testing
Discuss what is considered an ample period of time to decide if the medication is helping
Discuss your feelings and anxieties about medicating the child – do not be intimidated or pressured
Discuss the fact that you will have to do some research on the medication and make an informed decision.
If your childs doctor is pressured for time let him know that you will come back to discuss the issue
If your childs doctor does not provide you with the time – get a new doctor.
Titrating – when starting a child on a medication here is the golden rule – START LOW AND GO SLOW
Make sure that the pill or capsule that your child is taking is not time released and can be split before breaking
If the pill is time released see if there is a standard form of the drug to use for a day or two as a test
Having a bad reaction to a med is horrible – better it be six hours than 24 or more
Purchase a pill splitter they can be found at any pharmacy
Purchase a weekly pill box – yup like the old ladies have – this will help you remember if you gave it or not
Always keep a few pills in your purse – in the event that you are out at medication time
Although many medications have therapeutic levels there is no harm in starting low and going slow to get there…..
That is of course unless there is an acute life threatening crisis
Weaning off medications – take it even slower especially with antidepressant meds. Never stop antidepressant meds suddenly if they have been on board for a while
Some children especially those with PDD and other autistic features tend to be micro-responders.
I have found many drs tell you to increase the meds during exacerbations, I have found the opposite.
Use your intuition and gut – a moms gut is worth more than people give it credit
During exacerbations Temple Grandin had observed that she needed to lower her medications instead of increase them
All meds are not made the same – be careful of switching to generics or even the other way around
Take note when you switch brands of meds for changes in your child.
Over the counter meds MUST be checked on the interaction checker – MUST – I have provided a resource on FB
Herbs MUST be checked with the interactions checker – also provided resource on FB (including teas)
Many drugs cause vitamin deficiencies – especially stimulants – do your homework
Even if a medication cocktail is inevitable always insist on starting one at a time to not confuse the issue
If your child is on a medication requiring blood level tests – GET THERE – do not say tomorrow
Blood level tests are required for a reason – to check organ functions or to ensure safe levels – GET THERE
Be careful not to let the child get dehydrated as the concentration of the drug can increase
Be careful of grapefruit and other known foods that interact with many drugs also resource provided on FB
If you have a spouse or a partner – get on the same page – if you cannot agree seek consultation.
Always start a new medication on a Saturday if possible so that you can observe the child
If the child needs to take medications at school make an appt with the school nurse – discuss your child
Ensure that the child will be in a comfortable environment and not be embarrassed or stigmatized.
Are the drugs unaffordable for your family – there are programs that can help with providing medications
Call the pharmaceutical company manufacturing the drug to ask for assistance to see if they have a program
Be very very careful with clinical trials – parents get desperate to help their children- remember they are trials.
As much as you need answers, please remember as I said, it may take time to get the “correct diagnosis for your child and even longer to find effective treatment.
Don’t be afraid or embarrassed to ask for help yourself. If you are feeling overwhelmed say so.
Seek out a support group – check out online forums – read parent reviews such as remedyfind.com or healthrevolution.com
Give yourself a break – this is not easy – be pro-active and you will have a lot less to lose sleep over.
And remember, we are always here for you at The Coffee Klatch