Making the Decision to Medicate


Life is full of decisions, some of which are more challenging to make than others. I remember the first time we received psychological testing results about our son. The report was full of data and explanations, but at the end there was one sentence that really stuck out to me. It read something like, “Child will not be able to attend school in a mainstream classroom setting without medication, therapy, and significant accommodations.” 

Wow. It was a lot to process. 

My son was 5 years old. He was diagnosed at that time with ADHD, ODD (oppositional defiant disorder), and a mood disorder. All I saw was, “He would not be able to attend school without medication.”

It was a lot to think about. He was about to start kindergarten, but now I was being told he would not be able to handle it without significant help, including medications. I felt devastated.   

I had a lot of questions, but I knew I needed to make a decision that would help my child. I was told he had a medical condition and that medication would help him. If he had strep throat, the pediatrician would have prescribed antibiotics, and I would have given them to my son. If he was diagnosed with asthma, I am sure I would have started breathing treatments and gotten him an inhaler. So why was this such a difficult decision?

I have learned a lot since then. My son is now 15 and in the ninth grade. It was not an easy road getting there, but one thing I know for sure – without the help of medications, he would not be doing as well as he is now. I asked questions, did research, and monitored it all, but I am grateful for the doctors, researchers, and pharmaceutical companies that spend time and effort making sure there are medicines out there to treat mental health conditions.

You should ask questions before making the decision to medicate your child, but know that ADHD is a condition that affects the brain. It is a medical illness and medication is available to treat those symptoms. Just as heart disease will eat away at your heart if left untreated, ADHD can cause significant difficulty for a child at home, in school, and with social relationships. There are proven medications that can help a person with ADHD control the symptoms and allow them to improve functioning. 

Here are some questions to ask when making the decision on whether to medicate your child after receiving a diagnosis of ADHD:

Does my child have ADHD? ADHD can be difficult to diagnose, and its symptoms often mirror that of other similar conditions. Before starting any medications, ensure that you have an accurate diagnosis.  Your child should be evaluated by a trained professional who used the diagnostic criteria from the DSM-V.  The evaluator should ask for input from you, as well as your child’s teacher, when making a diagnosis. 

Why am I hesitant about medication? Think about why you are hesitant to medicate. Are you concerned that your child will be stigmatized for taking medication for their behavior? Remind yourself that ADHD is an illness, just like any physical illness. If your child’s condition goes untreated and they are unable to control their symptoms, they may struggle in school, and have difficulty controlling their behaviors. Without medication, they could be more likely to be teased, bullied, or develop negative self-esteem, which is more concerning than any possible stigma. As a parent, your job is to educate and help reduce the stigma associated with mental illness.

What are the risks/benefits of the medication? Prior to starting any medication, it is important to ask the prescribing doctor about any potential side effects and interactions with other medications. ADHD medications do have side effects, including sleep and appetite disturbances, but these side effects are minimal and can be monitored. In rare cases, there may be more serious side effects, but this is true with any medication. The benefits of taking the medication – improving school performance, higher self-esteem, lessening the risk of depression – most always outweigh the risks. 

What medication is best for my child? There are several types of medications used to treat ADHD, but stimulants are the most common, and doctors usually try stimulants first. Stimulants have been proven safe for children. These do not work for everyone, and for some, such as those that may have other conditions such as bipolar disorder or asthma, can make symptoms worse. Again, this is another reason it is important to get an accurate diagnosis and to ask your child’s doctor questions before starting medications. These medications can be taken in pill form, capsules, or in a patch. For children that do not tolerate pills, the capsules can be taken apart and the medication can be sprinkled on food. 

If stimulants are not appropriate, other medications can be prescribed. Blood pressure medications and antidepressants have also been used to treat ADHD for those that cannot tolerate stimulants. 

How will I know if it is working? Most ADHD medications work on a fast-acting, short-term basis. You should be able to tell if it is working quickly by noticing a change in behavior, both when the medicine takes effect and when the medication wears off. If you see no changes, you can determine that it is not an appropriate medication for your child. Discuss what you notice with the doctor, and he or she will prescribe a different class of medication or increase the dosage.   

Once you know that you have an accurate diagnosis, know that medication is the primary treatment for ADHD. Treating the symptoms of ADHD with medications allows a child to succeed at home and school, and can positively impact your child’s life. You have to do what you feel is right for your child, and by reading this article, it seems like you are on the right track of getting the information you need. As a parent, you have the right to ask as many questions as you need.

It is not an easy decision, and is not one you need to make in a vacuum. Work with your doctor, and use any resources available – I have found a lot of helpful information here. Other parents who have made the decision about medication – leave your tips in the comments below.

Tracy Greenberg has become a strong part of the Sheppard Pratt community. She is mother to Bryce, who attends The Frost School, part of the Sheppard Pratt Health System. She gives her time as part of the Consumer Advisory Council, a group of family members, former patients, former students, and employees of the health system who are dedicated to improving our quality of care and enhancing recovery from mental illness and addiction. Follow along with Tracy through her blog.