Evaluate the risk and benefits of using psychoactive drugs in children correctly diagnosed with a disorder versus those incorrectly diagnosed with a disorder.
As with the use of any psychoactive drug, there are risks and benefits. Although psychoactive drugs are not the number one choice for use amongst children, there may be times when medication should be prescribed. For example, when non-medical interventions are implemented and do not produce the desired effects, then the use of medications may an option. According to Advokat, Comaty and Julien (2014) especially in young children, pharmacological interventions are typically implemented when functional impairments are present along with symptoms that are moderate to severe and the risk of using the medication must be examined (p. 515). Clinicians should follow proper protocol for assessing and diagnosing disorders. Advokat, Comaty and Julien (2014) suggest a four step process which includes: step 1 is begin diagnosing using an appropriate assessment, step 2 is making a diagnosis, step 3 is creating and implementing a treatment plan without the use of pharmaceuticals, and finally step 4 is evaluate the use of pharmaceutical treatment as a last resort (p. 515).
Correct diagnosing is important in order to increase the likelihood of the medication to have a positive effect. If the diagnosis is incorrectly made, then the implemented treatment plan may not be beneficial. Prescribing psychoactive drugs when needed may cause necessary brain changes and produce desired outcomes, but may cause other negative effects such as cognitive impairments. Thus it is important to have the correct diagnosis in order to have a clear understanding of the desired outcome when prescribing psychoactive drugs amongst children.
Consider the risks and benefits of not treating (drug treatment) a child because he or she is not correctly diagnosed with a disorder.
Although some medications prescribed do not cure the disorder, they may benefit by reducing symptoms and behaviors that are associated with the disorder. For example, when prescribing medication for Autism, the disorder will not be cured, but may assist with various behavior symptoms and impairments that disrupt daily functioning amongst individuals (Advokat, Comaty and Julien, 2014, p. 520). Disorders that are left untreated may greatly impact development and various functioning that occurs in everyday life. Disorders related to aggression and negative behaviors if left untreated may cause symptoms to worsen and put the individual’s life as well as other individuals in danger. In addition, disorders such as depression if left untreated may cause symptoms to worsen and may even lead to suicide. Although various medications have been used to treat symptoms related to attention deficit hyperactive disorder (ADHD) it is essential to complete a thorough assessment and have an accurate diagnosis. ADHD symptoms vary amongst individuals and therefore it is essential for correct treatment plans to be implemented. If an incorrect diagnosis is made and a specific drug is prescribed, it may have adverse effects and not produce the desired outcome. Incorrect diagnosis and prescribing unnecessary medication may cause long lasting effects, which can be damaging and irreversible. Therefore, it is essential to monitor and ensure the desired effects are being achieved. The risks of drug treatment must be weighed and compared to the benefits of using the drug (Advokat, Comaty and Julien 2014, p. 522). Implementing a drug treatment plan should be well evaluated and continuously monitored.
Over diagnosing, underdiagnosing, or misdiagnosing of childhood psychiatric illnesses does occur. Unfortunately, this can lead to overmedicating, under medicating, or not medicating at all when it would produce benefits. Illnesses that are misdiagnosed and left untreated can actually cause damage and some of the damaging effects may be on brain development. According to Advokat, Comaty & Julien (2014) mental illnesses that are not recognized and not treated causes potential for emotional, social, and academic struggles during critical times in their life (p. 507). For example, ADHD that is misdiagnosed and left untreated may cause continued symptoms related to behavior, attention, and cognition damaging daily functioning and development.
In your evaluation summarize the natural course of the disorder, the drug action on the neurotransmitter systems in question, and the likelihood of short-term, long-term, and permanent positive and negative effects of drug treatment. Make sure to take into account the ethical dimension of this risk-benefit calculation.
Various mental disorders exist amongst children and adolescents. The effect on growth and development should be highly considered when prescribing medication to youth. Advokat, Comaty & Julien (2014) state mental health disorders are the chronic disorders amongst youth and if left untreated, the disorders are likely to continue throughout adulthood causing a defect in functioning (p. 507). For example, bipolar disorder may cause short and long term consequences affecting various parts of life including academics and social aspects as well as may even lead to suicide. Various types of bipolar disorder exist, but regardless of the type of disorder, it is common for other mental health disorders to develop. Although medications have existed for quite some time, second generation antipsychotic drugs are one of the most current treatment options. These medications assist in maintaining dopamine, noradrenaline, and serotonin levels in the brain. Antipsychotics mainly impact dopamine neurotransmitters which assist in regulating levels so the dopamine system is not overactive and reduce hallucination and delusion experiences. Short term side effects include drowsiness, decreased cognitive functioning, weight gain, tremors, tardive dyskinesia, and sexual dysfunction. Despite these effects, these drugs may assist with enjoying life and experiences such as interest in activities, increased motivation, taking care of one’s self, while reducing psychosis symptoms and suicidal thoughts. Since bipolar disorder is a continuous disorder, the use of medication will likely presume throughout a lifetime. Discontinued use of medications should be consulted with a physician. The risk and benefit of prescribing any drug should be considered. Health care professionals should evaluate the health and well-being of the individual and make good judgement based on the knowledge they know and what they feel is a good choice. Continuously making wise choices and decisions is critical for every individual.