Summary: Yes, there are many types of psychiatric medication considered safe for children and teens. Medications for depression, anxiety, ADHD, and other diagnoses approved by the Food and Drug Administration (FDA) for use by children and teens are both safe and effective at reducing symptoms and improving quality of life.
Key Points:
- All prescription medication passes several stages of testing for both safety and effectiveness.
- Medication for children and teens must pass stringent thresholds for safety, taking into consideration the enhanced vulnerability associated with stages of physical, emotional, and cognitive development.
- ADHD medication is the most thoroughly researched psychiatric/behavioral medication for children and teens.
Prescription Medication for Children and Teens With Mental Health and/or Behavioral Issues
If you’re the parent of a child or teen with a psychiatric or behavioral diagnosis, you may have received a referral for treatment for your child or teen, and they may have received a prescription for a psychiatric medication to help manage their symptoms.
This means you have to answer an important question:
Do I say yes to psychiatric medication for my child or teen?
To answer that question, you’ll probably ask two more:
Is it safe?
Does it work?
In general, whether a medication works or not depends on the individual. Some medications work well for some people but not others. Therefore, the answer to the second question is almost always “it depends on the individual,” because treatment progress is highly individualized, and is measured by goals determined by each patient.
In contrast, whether a medication is safe or not is more easily quantifiable: medications that pass safety tests are approved by the FDA, while those that don’t, aren’t approved by the FDA.
Thankfully for parents making this decision, there’s ample research on the topic.
In 2020, a group of mental health research scientists published a study called “Safety Of 80 Antidepressants, Antipsychotics, Anti‐Attention‐Deficit/Hyperactivity Medications and Mood Stabilizers in Children and Adolescents With Psychiatric Disorders: A Large Scale Systematic Meta‐Review of 78 Adverse Effects” in the peer-reviewed medical journal World Psychiatry: The Journal of the World Psychiatric Association (WPA).
The goal of the study was to assess whether various psychiatric medications are safe for children and teens. The research team conducted the study with hope that:
“The results of this comprehensive and updated quantitative systematic meta‐review of top‐tier evidence regarding the safety of antidepressants, antipsychotics, anti‐ADHD medications and mood stabilizers in children and adolescents can inform clinical practice, research and treatment guidelines.”
Below, we’ll share results from this study on the general safety profiles for ADHD medication, antidepressants, antipsychotics, and mood stabilizers.
First: A Disclaimer
This article does not contain any medical advice or a recommendation of one medication over another. The information we provide here is for educational purposes only.
We encourage you to make all decisions about medication for your child or teen in consultation with their prescribing psychiatrist, after a full discussion about the risks and benefits of each medication.
Risks refer to possible side effects or adverse events associated with the medication, while benefits refer to the positive impact the medication may have on mental health symptoms, daily function, and quality of life. The benefits of all the types of medication below include reduced symptoms, improved daily function, and improved quality of life. In contrast, the side effects and potential adverse events vary broadly by the type of medication and the specific medication prescribed.
Now let’s take a look at the results of this large-scale meta-analysis. This is an excellent category of publication to review because a meta-review or meta-analysis collects all the available information on a topic and identifies trends and patterns of fact consistent across all studies considered.
Psychiatric Medication for Children and Teens: Is it Safe?
For each type of medication we list above, we’ll share the age(s) for which they’re approved by the Food and Drug Administration (FDA) and the medications that show the least and most risk, according to the latest data. For sake of brevity, we won’t list all the specific drug names and all side effects that may accompany each type of medication.
To read those details, and review our source material for the following information, please refer to:
- The study we introduce and link to above.
- This resource from the State of North Carolina Department of Public Health: Psychotropic Medications in Children and Adolescents: Guide for Use and Monitoring
- This resource from the State of New Hampshire Department of Health and Human Services: FDA Approvals for Psychotropic Medications Used in Children With Mental Health Disorders
The study is relatively jargon-heavy, written for an audience of scientists and researchers, while the two state-level resources are presented in a simple, easy-to-understand table format appropriate for a general audience.
Let’s learn what they found, starting with ADHD medication.
ADHD Medication
Please discuss all details about all medications for your child or adolescent with your prescribing clinician and treatment team.
FDA Approval Status:
- Some types approved for children 3 and older
- Some types approved for children 6 and older
- Please discuss details about all medications with your prescribing clinician and treatment team
Common side effects may include insomnia, weight loss, stomach cramps/pain, hypertension, and drowsiness/sleepiness
Is this psychiatric medication safe for children and teens?
- Safety profile, ADHD medication:
- Safest profile: methylphenidate (Ritalin)
- Least safe profile(s): atomoxetine (Strattera) and guanfacine (Tenex, Intuniv)
Next, the results on antidepressant and anti-anxiety medication.
Antidepressant/Anti-Anxiety Medication
Please discuss all details about all medications for your child or adolescent with your prescribing clinician and treatment team.
FDA Approval Status:
- Selective Serotonin Reuptake Inhibitors (SSRIs)
- Some types not approved for people under age 18
- Some types approved for ages 12-17 for depression
- Others approved for ages 8 and up for depression
- One type approved for ages 8 and up for obsessive-compulsive disorder (OCD)
- One type approved for ages 6 and up for OCD
- Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
- One type approved for ages 10 and up for OCD
Common side effects may include nausea/vomiting, movement disorders, weight gain, sleepiness/drowsiness, diarrhea, headache.
Is this psychiatric medication safe for children and teens?
- Safety profile, antidepressant medication:
- Safest profile: escitalopram (Prozac) and fluoxetine (Lexapro)
- Least safe profile: venlafaxine (Effexor, not approved for people under age 18)
Now, the results for anti-psychotic medication.
Antipsychotic Medication
Please discuss all details about all medications for your child or adolescent with your prescribing clinician and treatment team.
FDA Approval Status:
- Many types not approved for any use for children and/or adolescents
- Some types approved for schizophrenia in adolescents age 13-17
- Some types approved for bipolar disorder in youth age 10-17
- One type approved for schizophrenia and bipolar disorder in adolescents age 13-17
- Some types approved for symptoms of irritability in various disorders for children and adolescents age 5-16
- Please discuss details about all medications with your prescribing clinician and treatment team
Common side effects may include sleepiness/drowsiness, movement disorders, weight gain, hormonal problems issues, elevated cholesterol, elevated glucose.
Is this psychiatric medication safe for children and teens?
Because of the serious, variable, and complex nature of the side effects associated with antipsychotics, and the fact that mental health disorders with psychotic symptoms and features in children and adolescents are rare, we advise parents to take advice about the safety of antipsychotics from their prescribing clinician. We’ll repeat: due to the nature of disorders with psychotic features and the variable side effect profiles of antipsychotic medications, we encourage parents to receive specific advice for their child or teen in the context of their treatment, their disorder, and their treatment goals.
Last on our list, the results on mood stabilizers.
Mood Stabilizers
Please discuss all details about all medications for your child or adolescent with your prescribing clinician and treatment team.
FDA Approval Status:
- One type (lithium) approved for manic episodes and maintenance of bipolar disorder in adolescents age 12 and up
- One type approved for seizures in people of all ages
- Two types approved for seizures in children age 2 and up
- One type approved for seizures in children age 4 and up
Common side effects may include sleepiness/drowsiness and weight gain.
Is this psychiatric medication safe for children and teens?
Lithium is considered safe for adolescents over age 12 with bipolar disorder.
That’s the end of our list. We’ll discuss these results below.
The Decision to Medicate: Your Child/Teen’s Level of Need, Your Family Beliefs/Values, and the Advice of Your Prescribing Clinician
If there were a simple, easy answer to the question of whether or not you should consent to psychiatric medication for your child, we’d provide it immediately. But since unique, individual factors drive these decisions, there’s no simple, one-size-fits-all answer to offer.
Factors to consider when – or before – talking to your prescribing clinician, typically a psychiatrist:
- The diagnosis itself has an influence on whether to use medication. Some disorders respond to medication well, while others don’t.
- The severity of the disorder, most often gauged by the level of disruption caused by the symptoms, will influence what your provider recommends.
- Your child/teen’s medical history, treatment history, and psychiatric history will influence what your provider recommends.
- Your provider will consider your family approach to medication, to treatment, and to mental health when making a recommendation.
- You and your provider will consider your child/teen’s goals for treatment when making a recommendation.
In all cases, your provider/prescribing clinician/psychiatrist will respect your decision with regards to medication, and complete your child/teen’s treatment plan to accommodate your decision. It’s a collaborative, patient – and in this case – family driven decision and process. Clinicians are there to help you and your family achieve the best possible outcome, based on your unique family culture, needs, and goals.
