1. Get a thorough checkup. Ideally, that means a complete physical, psychiatric, and developmental assessment by a pediatrician and pediatric psychiatrist. If all of those services are not available to you, at least consult with a mental health professional who specializes in children. Health insurance plans for individual patients and small businesses that take effect on or after Jan. 1, 2014, are mandated to provide coverage for mental health care under the Affordable Care Act.
“Forty percent of young children with mental health disorders have a language delay," Eggers said. "Others have hearing problems or learning disabilities or they may be taking an asthma medication that disrupts their sleep. We can address all of those things and a treatment plan will address multiple domains affecting the child and family.” In addition, identifying and treating conditions such as ADHD and depression can sometimes greatly improve the aggressive behaviors targeted by antipsychotic drugs.
2. Develop a treatment plan. Ask about the goals of treatment and how progress will be measured. The plan may include psychotherapy or cognitive behavioral therapy, parent-management training, and specialized educational programs. For very young children, these approaches should be tried for at least 12 weeks before medication is even considered. And even older children and teens are most likely to benefit from a treatment plan that includes nondrug measures.
3. Start low and go slow. If medication is warranted, your doctor should start it at the lowest dose possible and ramp up slowly if necessary. Except in rare cases, don’t use more than one antipsychotic drug at a time and make sure that you and your doctor monitor side effects carefully.
4. Know when to stop. If medication is part of the treatment plan, talk with your doctor about tapering off after 6 to 9 months to see if it is still helpful and necessary.
5. If necessary, get a second opinion. “Studies show wide variations in how these drugs are used,” Bellonci said. If a doctor prescribes an antipsychotic drug without following through on the basic steps outlined above, consider consulting with another healthcare provider.