Use of drug therapy in treating children is a relatively new field. Many drugs prescribed for similar conditions in adults are not FDA-approved for children, and some are only approved for children over the age of 12. When drug therapy has been prescribed for a child, it is imperative that the parents or caregivers learn about the proper dosages, possible side effects, and harmful interactions with other medications. If the medications are to be administered at home, extra precaution should be taken to keep them in a safe and secure place.
An estimated 12 million children in the United States suffer from some form of psychiatric illness, including attention deficit/hyperactivity disorder (ADHD), major depression, schizophrenia, Tourette's syndrome, anxiety disorders, and autism. Because research has shown that many psychiatric illnesses are biological in origin, drug therapy is often the prescribed treatment. However, the medications can evoke side effects such as irritability, agitation, nausea, and headaches. The stimulants used to control ADHD can suppress growth, particularly weight gain. Schizophrenia is treated with antipsychotic agents such as chlorpromazine, thioridazine, haloperidol, and thiothlxene. Long-term use can produce tardive dyskinesia, an involuntary tongue and mouth movement disorder, stiffness, and tremors. Clomipramime, an antidepressant effective in the treatment of obsessive-compulsive disorder in adolescents, can produce dry mouth, blurred vision, constipation, rapid heartbeat, and urinary retention. Muscle stiffness often accompanies the drug haloperidol when it is taken for Tourette's syndrome.
Chemotherapy, a short-term program of drug therapy prescribed after cancer surgery to delay or stop the growth of cancerous cells, typically causes serious side effects. This is due to the fact that healthy cells are destroyed as well. The most common side effects are hair loss, nausea, and fatigue. Sometimes side effects disappear over time. In other cases, additional medication is prescribed to minimize side effects of other drugs.
Possible drug interaction is a concern. Recently it was found that the antibiotic oral rifampin prescribed for the prevention of the meningoccal virus in children can interfere with drugs the child may be taking for seizure prevention. Under the Omnibus Reconciliation Act of 1990, pharmacists are strongly encouraged to maintain patient files for effective drug therapy management. Parents should make sure that their local pharmacy has a record of their child's drug history.
Some physicians and pharmacists believe the time of day a drug is taken can determine its effectiveness. Because body temperature, blood pressure, and pulse rate are at their lowest in the pre-dawn hours, asthmatics often suffer attacks in the early hours when lung power is diminished. Therefore, many physicians prescribe a long-acting beta-agonist that can be taken at bedtime and last 12 hours.
Many parents also worry that their children will become addicted to medications. While antidepressants and antipsychotic drugs are not addictive, benzodiazepines and stimulants can be, and they should be monitored carefully.
Cardoni, Alex S. "Drug Therapy of Psychiatric Disorders in Children." American Druggist 208, September 1993, no. 4, p. 65.