If your child is taking medication to control the symptoms of ADHD or other related disorders, it can feel very daunting to make any changes to his or her medication treatment protocol. I know about this firsthand as we are currently in the midst of changing my son’s meds. I can tell you that, so far, it has been quite an emotional rollercoaster ride for everyone involved.
It is one thing to read about medications from a textbook or clinical perspective, but it is quite another to read about the human experience of living through a medication change. The textbook descriptions can’t really tell you how to cope with such changes nor about the small (but extremely important) details which can greatly affect how the process will go. I am here to share my experience as a parent in changing my son’s medications and all the lessons I am learning along the way.
The first step in this process is to figure out if you actually do need to change your child’s medication. Two popular reasons for wanting to change medications are either that the side effects are too much to handle or that the medication has been deemed ineffective and is not doing what it is supposed to do. In our case, we felt that my son’s Prozac was no longer working as it had been previously.
The process of changing your child’s meds may begin with a conversation which may go something like this:
" I am wondering if (name of drug) is working anymore. He isn’t as (calm, happy, focused) as he used to be." The other person you are talking to, whether it is your spouse, your child’s teacher, or family member may respond in agreement. Then they may add that they have also seen some negative behaviors as in: "I think you are right and in fact (he/she) seems (more on edge, hyperactive, depressed, inattentive and so forth)."
It is good to talk about this with others who may either agree or disagree with your assessment. Questions you may ask before considering a change in medication:
"¢ How long has your child taken the medication? If it has been less than six or eight weeks then you really aren’t giving it a long enough chance to work. Most medications take a month or two before you see the full therapeutic benefit.
"¢ Have you tried a change in dosage under the supervision of your child’s doctor? Sometimes a simple change in dosage can make all the difference in either decreasing side effects or improving effectiveness of the medication.
"¢ Is your child getting his or her medication as prescribed? Sometimes things like whether or not the pill is given the same time each day, or whether you take food or not with it, can make all the difference in the world. You want to ask your child’s doctor how the medication should be taken for maximum therapeutic benefit.
"¢ Can the changes in the behavior we are seeing be caused by stressors in my child’s environment? Medication is not given in a vacuum. There are always life circumstances which may tip the balance of your child’s mood and behavior. No pill is going to overcome life challenges such as being bullied at school, moving to a new town, or a divorce in the family. Things like talk therapy or counseling may help in addition to any medications.
"¢ Have we exhausted all the behavioral and non-prescription methods to address the adverse changes we are seeing in either mood or behavior? You want to consider whether or not environmental and behavioral changes could help decrease any of the negative behaviors you are seeing. Does your child have a consistent behavioral program and good supports? Is he or she getting a good night’s sleep? Is your child’s diet healthy?
In our situation my son had been taking Prozac for over two years and when we saw the mood swings, tearfulness, and agitation return, we felt that maybe the Prozac wasn’t as effective any more. In addition, my son was increasingly short-tempered and was beginning to act out. We initiated a change under his doctor’s guidance of increasing the dosage of Prozac. When this change did not produce any noticeable results, we decided a more dramatic change was necessary - as in having him try new medications.
It took about four months to make this decision, as we were not able to see my son’s neurologist for all this time between appointments. During the time we were waiting, we increased his supports and fine-tuned his behavioral plan. I wanted to make sure that we were doing everything possible to help him before changing his medication so that it would have the best chance to work.
We also did a lot of research about the different medications which might help our son, so that we would understand what we were getting into as far as things like side effects. I read both the clinical reports as well as the personal experience stories from parents. We narrowed our choices down to several medications which we would then ask about during our next doctor visit.
In my next post I will continue my story of how we made the choice of which new medications to use and how that change is going so far. I feel for any parent or family and especially the child who is undergoing a medication change. The process is not for the faint of heart.
If you have undergone this process of having your child change their medication we would love to hear from you. Remember that you are the experts here. There is much to be learned by sharing our stories and experiences with one another.