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Warnings about possible side effects of prescription medications are updated frequently. To stay abreast of recent warnings that may have been issued on your child's medication, visit the Food and Drug Administration's drug-safety index website, and ask your pharmacist for an update each time you refill the prescription.
By Shashank V. Joshi, M.D.,FAAP
Medication side effects are usually transient and minimal. Your child's practitioner will go over specific side effects, depending on what is prescribed. In general, stimulants are known to cause headache, stomachache, small increases in blood pressure and pulse, appetite suppression, and sleep difficulties. Less common side effects include irritability, mood changes, unmasking of tics, and slowing of the speed of growth in height. All of these are responsive to simple interventions, such as giving the dose with food, lowering the dose, changing its timing, or switching to another medicine.
Recently, the FDA has included new warnings regarding the use of Strattera (atomoxetine) — it has, on rare occasions, been associated with suicidal thinking in teenagers — and also for psychostimulants (they have a rare association with severe cardiac side effects and sudden death, primarily for children with a history of certain pre-existing heart problems).
The FDA link regarding drug safety information for patients and families can be found at here.
How you talk to your child about medication depends, in large part, on your child's developmental stage. Younger children (5 to 7 years old) need reassurance they're not "bad" kids. They need to know their parents understand that they're trying really hard to behave, pay attention in class, or stay in their seat. The medicine will make it easier for them to succeed because it allows them to make good choices and be in control of their behavior and attention, rather than being controlled by their behavior.
Older school-aged and preteen children (8 to 12 years old) also need constant reminders about, and attention to, things they can do well, rather than having their parents dwell on their difficulties. Medical analogies can be helpful, like, "You know how getting eyeglasses helped you [or your friend or your cousin] a lot with schoolwork? That's sort of how this medicine is supposed to help too."
Teens need to know it's not "all about the pill." When their grades turn around, they did it; the medication simply allowed them to focus long enough to actually get the work done. The teen still had to do the homework or finish the paper. Meds can't take tests! Emphasize that you, he, the doctor, and his teachers are all on the same team, trying to help him succeed.
Just as it's usually not a good idea to keep family secrets, keeping school personnel in the dark about your child's ADHD is generally not helpful either. While it may be difficult to secure appropriate accommodations at certain schools, most schools do want to support their students. Your child's practitioner, school psychologist, or counselor may have some practical classroom suggestions. Work with your child's teacher to create a special "signal" (e.g., a gentle squeeze on the shoulder, or an opportunity to do a special errand) when it's time to go to the office or nurse's station to take midday medication. Once-daily preparations make these kinds of arrangements unnecessary, but for those who respond better to shorter-acting agents, it's crucial for maintaining confidentiality.
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