Overcoming Fear of Psychiatric Medication in Children



Written by Dr. Daniela Graf, Child Psychiatrist at The Valens Clinic.

As a consultant child and adolescent psychiatrist and psychotherapist, I can say that many teenagers find it quite “cool and trendy” to have their own therapist. Teachers, too, are increasingly alert to identify mental health challenges in their students and to advise parents to seek help early. The earlier a patient gets adequate help, the sooner he will recover and consequential damages will be avoided.

Almost all of my patients’ parents are very open in my consultation when it comes to accepting and implementing therapeutic recommendations. Sadly, this usually only applies to recommendations such as psychotherapy, play therapy, family therapy, occupational therapy or speech therapy.
However, when it comes to supportive psychiatric medication, as a child psychiatrist, I sense a significantly heightened level of anxiety and reticence. Most parents express concerns such as “my child is too young”, “it has so many side effects”, “it will make my child dependent” or “my child will learn to rely on a pill instead of working on his/her challenges”. And yes, I can absolutely understand these initial thoughts and fears. If I were not a child psychiatrist, I would have the exact same thoughts.
Therefore, it is of absolutely indispensable importance to deal intensively with these arising questions during the initial consultation and to inform the parents and children as detailed as possible about potential benefits, risks and side effects. In my experience, this is where it fails: often I see families who have seen 2-3 other doctors before and described to me “the doctor saw my child for 5 minutes and without any further tests we were sent home with a prescription”. The problem with this is that such an approach not only ignores the fears of the parents, but may actually lead to medication being advised unnecessarily or not being appropriate for the child’s condition.
If, on the other hand, a medication is chosen carefully and this decision is discussed in detail with the entire family, then a psychiatric medication can be very helpful. In 13 years of child psychiatric practice in various settings including Dubai and Germany, I have prescribed medication to thousands of patients and not one patient has ever suffered a serious side effect. The most common side effects (depending on the category of medication) are fatigue, sleep disturbances, appetite changes, nausea. However, these side effects usually disappear after a few days of use.
If you put these mild undesirable symptoms of a medication in relation to the original symptoms for which the child was brought in (suicidal ideation, self-injurious behavior, substance abuse, trauma, school refusal, severe anxiety and depression), then the risk-benefit ratio is clearly in favor of the benefits.
Most psychiatric medications prescribed today have been on the market for decades and have resulted in millions of people experiencing significant improvements in their medical condition and quality of life.
Therefore, as a child mental health professional, I would urge all physicians to take enough time to adequately educate their young patients and more importantly parents in order to give us child psychiatrists an honest chance to support children with mental health challenges in the best possible way.