Medication Considerations for Special Groups

Children

Certain medications are safe and effective for children, while others haven’t been researched yet. Doctors may treat children by prescribing these medications “off-label.” Questions remain about how these medications affect a child’s growing body and brain. Parents need to know the options and research to best make decisions on their child’s behalf.

Children may also experience different side effects than adults. Antidepressants, for instance, carry what is referred to as a “black box warning,” explaining that they may increase suicidal tendencies in young people. Because of these uncertainties, the provider and family should monitor children and teens closely when they’re taking a psychiatric medication.

Pregnant Women

A pregnant woman (or a woman who may be pregnant or want to become pregnant) with a mental health condition faces additional risks with medication. Women who stop taking psychiatric medications because of pregnancy may experience recurring symptoms, which can be dangerous for mother and child. However, some medications can be transmitted to the infant through the placenta or breastfeeding. Women should discuss the pros and cons with their doctor. After giving birth, women should also consult their doctor about how to prevent postpartum depression.

Older Adults

As we age, our bodies process medicines more slowly, so older adults may need lower dosages. We’re also more likely to take multiple medications, increasing the risk of unexpected and dangerous drug interactions. Possible memory problems may cause older adults to miss doses or accidentally overdose. Certain side effects are also more common in older adults, such as tardive dyskinesia. For these reasons, older people should carefully monitor their treatment and symptoms. Geriatric psychiatrists may help inform decision-making for the elderly.

Members of Specific Cultural Groups

Certain ethnic groups respond differently to medication, though more research is needed. Some African-Americans and Asian-Americans, for instance, metabolize some medications more slowly than Caucasians. This places them at increased risk of certain side effects. Luckily, genetic tests can help us to better understand who is a fast or slow metabolizer of psychiatric medicines.

For many ethnic groups, treatment is also complicated by language barriers, socioeconomic stresses, lack of minority health care professionals and stigma. To improve the odds of recovery, reach out to culturally competent mental health providers when possible. They can help locate support groups and other doctors who consider culture and ethnic background.

 

Reviewed August 2017