For Families > Disorders and Treatments > A-Z Disorder Guide > Schizophrenia

Guide to Psychiatric Medications for Children and Adolescents

by Glenn S. Hirsch, MD
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The following guide includes most of the medications used to treat child and adolescent mental disorders. It lists the problems each medication might treat and some of the common side effects. This guide is intended to be informative and useful, but it is not comprehensive. Children should take these medications only under the careful supervision of their physicians.

Listed are only those adverse effects that occur more commonly and those that are rare but potentially serious. Always alert your physician about any other medications, over the counter pill and 'alternative treatments' that you may be taking.

Class: Stimulants

Benefits: Treats the core symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) including, impulsivity, hyperactivity and inattention. There is very little documented difference in the effectiveness between the amphetamine and methylphenidate medicines. However, some children respond to one group better than another.

Side Effects: Loss of appetite, difficulty falling asleep, irritability and /or moodiness. Some children may develop tics while on the medicine while those with a tic disorder may find that the tics worsen. Both growth and weight should be monitored, since weight loss can occur, and there is some evidence that stimulants may cause a slowdown in growth. Very rarely they may cause hallucinations or exacerbate manic symptoms These medications can increase blood pressure and pulse slightly. Please tell your doctor if there are any relatives with a history of heart disease at an early age.

MEDICATION NAME NOTES
Brand Name Generic Name**
Ritalin
Focalin
Methylin
Methylin Chewable
Methylin Liquid
methylphenidate These are short acting—generally lasting about 3–4 hours.
Concerta
Focalin XR
Metadate CD
Ritalin LA
Daytrana Patch
methylphenidate These are long acting—generally lasting about 8–12 hours. Each one is formulated somewhat differently but there is generally no way to determine which will last the longest for any individual.
Daytrana is the newest and uses a patch to deliver methylphenidate through the skin. The patch may cause some skin irritation.
Dexedrine
Dextrostat
Adderall
amphetamine These are short acting—generally lasting about 3–6 hours. Each one is formulated somewhat differently but there is generally no way to determine which will last the longest for any individual. Adderall is a mixture of different forms of amphetamine (amphetamine salts).
Adderall XR amphetamine salts Lasts 8–10 hours
Dexedrine Spansules amphetamine Lasts 8–10 hours


Class: Non-Stimulant (Selective Norepinephrine Reuptake Inhibitor)

Benefits: Treats the core symptoms of ADHD. May not have as robust an effect on symptoms as the stimulants but may help individuals who have anxiety along with their ADHD.

Side Effects: Decreased appetite, nausea, insomnia or tiredness, dry mouth.

MEDICATION NAME NOTES
Brand Name Generic Name
Strattera atomoxetine Has the potential to last 24 hours. Can often be given just once a day although some patients require a second dose in the late afternoon. Unlike most medications this one is dosed based upon the patient's weight.


Class: Antihypertensive

Benefits: Historically used for the control of high blood pressure. Often used as a first medical treatment for the tics of Tourette Disorder. Can be useful in treating the hyperactive and impulsive symptoms of ADHD. Can sometimes help with children who have aggressive behaviors. Generally not useful for the inattentive symptoms.

Side Effects: Dry mouth, sedation, dizziness. Rarely can trigger depressive symptoms.

MEDICATION NAME NOTES
Brand Name Generic Name
Tenex guanfacine The TTS is a patch that is changed every 3–4 days. It may cause local irritation.
Catapres, Catapres TTS patch clonidine


Class: SSRIs or SRIs (specific serotonin reuptake inhibitors)

Benefits: Useful for depression, obsessive-compulsive disorder and anxiety disorders.

Side Effects: Appetite changes, nausea, headache, sweating, insomnia and occasionally tiredness, delayed ejaculation, decreased sexual desire.

MEDICATION NAMENOTES
Brand Name Generic Name
Prozac
Serefam
fluoxetine Prozac was the first of this group of medications to be approved by the FDA. While there are some minor differences between these medications, they share more similarities than differences.

As a group they affect the neurotransmitter Serotonin.

In rare situations, during the early phases of the treatment for depression some individuals can have the onset or increase in suicidal thinking; therefore your physician will have guidelines on how frequently he needs to see the patient.
Zoloft sertraline
Luvox fluvoxamine
Paxil
Paxil Cr
Pexeva
paroxetine
Celexa citalopram
Lexapro escitalopram


Class: Tricyclic Antidepressants

Benefits: This group has been used to treat depression, ADHD, enuresis and chronic pain. Unlike the other tricyclics, Anafranil is used to treat OCD.

Side Effects: Sedation, weight gain, nausea, dry mouth, constipation. May cause changes in heart rhythm.

MEDICATION NAME NOTES
Brand Name Generic Name
Tofranil imipramine This group of medications is now rarely used for the treatment of depression or ADHD. The SRI's have generally replaced them for the treatment of depression and Strattera has replaced them for the treatment of ADHD.

As a group they have effects mainly on the neurotransmitter norepinephrine and less so on serotonin.
Norpramin desipramine
Elavil amitryptyline
Pamelor nortriptyline
Sinequan doxepin
Anafranil clomipramine This was the first medication approved in the U.S. for the treatment of OCD. Sometimes used to augment the SRIs.


Class: Other Antidepressants

Benefits: For depression. Used for the treatment of smoking cessation (under the name Zyban) Has been used to treat symptoms of ADHD. Generally not useful for anxiety disorders.

Side Effects: dry mouth, decreased appetite. At high dose may increase susceptibility to a seizure.

MEDICATION NAME NOTES
Brand Name Generic Name
Wellbutrin
Wellbutrin SR
Wellbutrin XL
bupropion Bupropion looks chemically similar to the amphetamines.


CLASS: Other Antidepressants

Benefits: Treats depression. May be helpful in anxiety. Some studies suggest that they can be helpful for depression where physical complaints (e.g. headaches, general pain) are a dominant feature.

Side Effects: Generally similar to the SSRI group. Remeron and Cymbalta tend to be sedating.

MEDICATION NAME NOTES
Brand Name Generic Name
Effexor venlafaxine Has occasionally been used to treat ADHD especially in adults.
Effexor XR venlafaxine Long acting version of Effexor.
Remeron mirtazapine  
Cymbalta duloxetine This medication has both elements of both the SRI and the tricyclic antidepressants.


Class: MAOIs (monoamine oxidase inhibitors)

Benefits: Used to treat treatment-resistant depression and anxiety.

Side Effects: Dizziness, sedation gastrointestinal symptoms, low blood pressure, changes in appetite and weight.

MEDICATION NAME NOTES
Brand Name Generic Name
Nardil phenelzine These medications are rarely used in children and adolescents. Tyramine, an amino acid in some foods can interact with these medications to trigger severe high blood pressure. People taking them must follow a restricted diet (Emsam at lower doses does not require the diet).
Parnate tranylcypromine
Emsam patch selegiline


Class: Antipsychotics (sometimes called Neuroleptics)

Benefits: Treats psychosis, schizophrenia, bipolar disorder and aggression. Orap and Haldol are used to treat Tourette Disorder. Has been used to treat behavioral symptoms of Autism.

Side Effects: Dizziness, sedation, dry mouth, constipation, blurred vision, increased appetite, restlessness, muscle stiffness. Prolonged use may result in a movement disorder called tardive dyskinesia.

MEDICATION NAME NOTES
Brand Name Generic Name
Haldol haloperidol With the introduction of newer antipsychotics these medications are used much less frequently.

This is only a partial list of the medications in this class.
Orap pimozide
Prolixin fluphenazine
Mellaril thioridazine
Thorazine chlorpromazine
Stelazine trifluoperazine
Moban molindone
Loxitane loxapine


Class: Second generation (atypical) antipsychotics

Benefits: Treats psychotic conditions such as schizophrenia, can be useful in helping stabilize mood in bipolar disorder and in impulsive/aggressive behavior.

Side Effects: Weight gain, sedation, dizziness, insulin resistance, muscle stiffness.

MEDICATION NAME NOTES
Brand Name Generic Name
Risperdal risperidone Has been studied in the treatment of aggression and irritability in Autism.
Zyprexa olanzapine  
Seroquel quetiapine  
Geodon ziprasidone  
Abilify aripiprazole  
Clozaril clozapine May be the most effective medication in treatment resistant psychotic conditions. Must get weekly blood tests to monitor for a rare side effect that can depress the formation of blood cells.


Class: Anxiolytic (benxodiazepine)

Benefits: Reduces panic anxiety symptoms. Generally used for short term treatment.

Side Effects: Sedation, dizziness.

MEDICATION NAME NOTES
Brand Name Generic Name
Xanax
Xanax XR
alprazolam Can cause paradoxical hyperexcitability especially in young children.
Is occasionally used for the treatment of mania. Often works immediately.
Klonopin clonazepam
Ativan lorazepam


Class: Anxiolytics

Benefits: Used for the treatment of general anxiety symptoms—not helpful for separation anxiety or social phobia.

Side Effects: Dizziness, nausea, sedation.

MEDICATION NAME NOTES
Brand Name Generic Name
Buspar buspirone Often takes several weeks to work.


Class: Hypnotics (sleep)

Benefits: Enhances sleep onset and quality of sleep.

Side Effects: Dizziness, can cause paradoxical hyperexcitability especially in young children.

MEDICATION NAME NOTES
Brand Name Generic Name
Ambien
Ambien CR
zolpidem These medications are generally not used as a first line treatment of insomnia. Understanding and dealing with the underlying issues that are disrupting sleep is always the first step.
Lunesta eszopiclone
Sonata zaleplon
Rozerem ramelteon


Class: Mood Stabilizers

Benefits: Treats the symptoms of bipolar disorder.

Side Effects: Excessive thirst, frequent urination gastrointestinal symptoms, acne, weight gain.

MEDICATION NAME NOTES
Brand Name Generic Name
Lithium
Lithobid
Eskalith
lithium Requires frequent monitoring of lithium blood level, thyroid and kidney functioning. Excessive doses are dangerous. The most established and well studied medication for bipolar disorder.


Class: Anti-Convulsants (anti-seizure)

Benefits: This group of medications has been used in the treatment of bipolar disorder and aggressive behavior.

Side Effects: Sedation, tremor, gastrointestinal distress, weight gain.

MEDICATION NAME NOTES
Brand Name Generic Name
Depakote divalproex
valproate
Well studied in the treatment of bipolar disorder. Has been used as a treatment of migraines. Requires occasional lab tests. May cause polycystic ovary disease.
Tegretol
Carbatrol
carbamazepine Well studied in the treatment of bipolar disorder. Requires occasional lab tests.
Trileptal oxcarbazepine A newer version of carbamazepine.
Lamictal lamotrigine Appears to be very helpful in treating the depressive phase of bipolar disorder but is not clearly helpful in the manic phase. Very rarely, can trigger a life-threatening rash.

The utility of the following medications in bipolar disorder is still under investigation.
Topamax topiramate Does not cause weight gain.
Neurontin gabapentin There is some evidence that it can be helpful in treating anxiety disorders.

*The class of a medication is often a useful way of grouping similar medications. However, there is no particular format or rule for this and therefore the class name is somewhat arbitrary. The name can signify it most common use (many of these medications can treat more than one disorder), its mechanism of action or rarely some side-effect.

**The brand name of a medication is the name a company will use to sell its unique formulation of a medication. When a drug is first developed it will have two names. The first is the name which describes its chemical structure but is never used outside the laboratory. The second is what will be its generic name. This name will be used until the medication is approved by the FDA and ready to be sold to the public. Once the medication is ready for sale it will be given a brand name. After the patent expires other companies will be allowed to make the medication and it will generally be sold under the generic name. (The following example will illustrate the various names for a single medication. See if you can guess what the medication is from its chemical name: N-Methyl-gamma-[4-(trifluoromethyl)phenoxy]benzenepropanamine, Not sure? Its generic name is fluoxetine. Still not sure? The brand name is Prozac.