Why Use Antipsychotic Medications in Childhood?

Parents may be surprised to hear that antipsychotic medications are a common treatment for childhood attention-deficit/hyperactivity disorder (ADHD). They're often prescribed to help children who experience intense mood swings, aggression, destructive behaviors, or self-harm. These medications can be life-changing and life-saving, but the term "antipsychotic" is so stigmatized that parents might be terrified when doctors recommend antipsychotics. Of course, always consider the risks, but also consider the benefits of using antipsychotic medications in childhood.

Antipsychotic Medication and My Child with Mental Illness

A psychiatrist first suggested antipsychotic medication in my son's childhood, when my son was eight years old. He had been so suicidal, assaultive, and dangerous that he required two weeks in the hospital. I was at my wit's end. We'd spent three years trying to manage these behaviors through therapy, a neuropsychologist, an individualized education plan (IEP) at school, and a stimulant for his ADHD. Nothing helped the aggression, destruction, or screaming fits. Those were the result of his disruptive mood dysregulation disorder (DMDD) and the psychiatrist said an antipsychotic could help.

I work with adults with serious and persistent mental illnesses, so I know antipsychotics. To me, they were adult medications, with adult complications, not something for an eight-year-old. Because of this, our family waited longer before trying the antipsychotic than we probably should have.

What Is an Antipsychotic?

Antipsychotics are also referred to as neuroleptics. To be honest, I tend to say "neuroleptic" because people are less quick to judge than if I say my child is on an "antipsychotic."

As the word implies, antipsychotics are traditionally used to treat psychosis. Psychosis includes symptoms such as false beliefs (delusions) or experiencing things that aren't there (hallucinations). Most people associate psychosis with schizophrenia. Psychosis can be caused by drug use, however, or various other disorders.

Weighing the Pros and Cons of Antipsychotic Medication in Childhood

Talk to your child's doctor to decide whether an antipsychotic is appropriate. The benefits don't always outweigh the risks. Common side effects include dizziness, weight gain, and a higher risk of diabetes, just to name a few. Long-term antipsychotic use also increases the risk of tardive dyskinesia, which is a neurological disorder characterized by involuntary muscle movements.

Why would anyone read a brief list of scary-sounding side effects and then subject his or her child to the medication? For my family, it's because the benefits do outweigh the risks. My son's behaviors were going to kill him, either by accident or via self-harm. He was going to harm other people in the midst of his rages and explosions. We lived in constant fear.

Within a week of his starting the antipsychotic, he was smiling. The anger cleared and revealed a sweet, happy kid. His antipsychotic didn't change who he was or turn him into a zombie, or all those things people fear. It allowed him to be himself and our family could breathe easier. It does make him very hungry, but his stimulant tends to counteract that. Yes, he still goes into rages at times, but they're fewer and farther between. They're less intense, and for the days or weeks in-between them, we have a content kid.

Yes, be skeptical and question your doctor. Questions are important before, during, and after medication use. We continue to monitor our son. The doctor does side effect assessments. We ask about concerns and we hope, one day, he can maybe come off the medication.

We aren't complacent, but we're all definitely happier.

What is your experience with using antipsychotic medication in childhood?