Medication Management

Written by Tara Peris
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Medication management is a hot topic in the field of child and adolescent psychiatry. As debate swirls regarding if, when, and how children should be medicated, psychologists and psychiatrists have been forced to rethink many aspects of how mental health services are delivered to our youth. One can expect dramatic reform proposals to emerge in the months and years to come.

For the last several months, newspapers have covered the controversy over whether antidepressant medications increase suicidal tendencies in children and adolescents. Stories of this nature are easy to sensationalize, and the central issues are, in fact, quite complex. To be sure, our understanding of medication management for children taking antidepressants remains far from complete. Moreover, the relative contributions of age, dosage, and environmental considerations in predicting suicide have yet to be examined empirically. Thus, we have an association between two variables, but no clear idea of how this relationship is interrelated.

Understanding Medication Management for Antidepressants

How is the association between antidepressants and suicide explained? Many argue that for both youth and adults, antidepressant medications may provide a boost of energy, but in actuality it causes excitability. This boost coupled with residual feelings of sadness that have not been treated via psychotherapy can give some patients the necessary push to carry out their suicidal plans. Clearly, consequences of this degree require psychologists and psychiatrists to act with the utmost caution when determining an appropriate treatment plan.

The solution to the complex issue of appropriate medication management is likely to unfold in stages. For now, the focus is on improved scientific research and on clearer warning labels for prescription pills. Practitioners are lobbying for drug companies to disclose all clinical trial results so that professionals can make more informed decisions about drug safety.

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