Psychiatric medications for children are often misunderstood. Some parents hesitate to start them even when the child is suffering, while others expect medication to “fix everything.” The truth is somewhere in between.

Medication is neither magic nor madness. It is a tool — and like every tool, it must be used at the right time, in the right way, with proper supervision.

🧩 Before Medication — What Should Be Tried First?

For mild to moderate symptoms, non-pharmacological approaches are the first line.

✅ 1. Behavioural Therapy

Particularly effective in ADHD, autism, conduct problems, habit disorders.

• Reward charts, positive reinforcement

• Structured routines, token economy

• Sensory regulation strategies for autism

✅ 2. Parenting Interventions

Children don’t grow in isolation — behaviour depends on parenting patterns.

• Consistent rules, predictable consequences

• Avoid shouting/spanking — use structured discipline

• Parent Management Training (PMT), Triple P Parenting

✅ 3. School-Based Interventions

• Seating near the teacher

• Shortened tasks, extra time for exams

• Special educator involvement, IEP (Individualized Education Plan)

✅ 4. Psychotherapy / Counselling

• CBT for anxiety, depression, OCD

• Play therapy for younger children

• Social skills training for autism, ADHD

✅ 5. Lifestyle Corrections

👉 If symptoms improve, medication may not be needed.
👉 If symptoms persist, disrupt schooling, social life, or safety — medication should be considered.

🚦 When Should Medication Be Started? (Red Flags)

Medication becomes necessary when:

✔ Symptoms cause academic failure & social withdrawal
✔ Child becomes aggressive, self-harming or unsafe
✔ Anxiety/depression leads to suicidal thoughts
✔ OCD rituals consume hours every day
✔ ADHD affects learning, friendships, and self-esteem despite therapy
✔ Psychosis, bipolar disorder, severe mood swings

Delaying treatment can harm brain development more than medication itself.

📊 How to Monitor a Child on Medication

🛑 When & How to Stop Medication

Stopping psychiatric medication needs planning — not sudden withdrawal.

✅ Medication can be tapered if:

• Child is symptom-free for 6–12 months

• Behavioural and academic functioning is stable

• Family and school environment are supportive

• No relapses in recent months

❌ Medication should not be stopped if:

• Child has severe/chronic psychiatric illness (autism with aggression, bipolar disorder, schizophrenia)

• Prevents relapse (e.g., depression, OCD)

• Stopping causes behaviour regression or school decline

⚠️ How to Stop Safely:

1. Never stop abruptly (risk of withdrawal, relapse)

2. Gradual tapering over weeks/months

3. Monitor behaviour, sleep, academics closely

4. Maintain therapy, school support during withdrawal period

5. Restart if symptoms reappear

🧠 Medication + Therapy = Best Outcome

Medication alone makes the brain ready to learn and listen.
Therapy and parenting strategies teach the brain what to do with that readiness.

🌟 Final Takeaway for Parents & Clinicians

✔ Medication is not the first step. But it should not be the last resort either.
✔ Start when suffering > side effects. Continue only if benefits are visible.
✔ Teach skills, not just silence symptoms.
✔ Grow the child, not just control the child’s behaviour.

👨‍⚕️ About the Author

Dr. Srinivas Rajkumar T
MD (AIIMS, New Delhi), DNB Psychiatry
Consultant Child & Adolescent Psychiatrist
Mind & Memory Clinic – Apollo Clinic (Opp. Phoenix MarketCity), Velachery, Chennai – 600042
📞 +91-8595155808 | 🌐 www.srinivasaiims.com

Specialised in ADHD, autism, school refusal, childhood depression, behavioural issues and safe psychopharmacology in children.