How Atypical Antipsychotics Work
When atypical antipsychotics have been used to treat children and adolescents, they have been discovered to have the greatest effect in kids with very aggressive symptoms associated with ADHD and some of the other disruptive behavior disorder experiences discussed in Chapter 3. They have also been used for kids with autism, Tourette's syndrome, and anxiety or eating disorders. However, atypical anti-psychotics are most often prescribed for children and teens to treat persistently defiant and aggressive behaviors. Atypical antipsychotics are also used (and FDA-approved for adult use) as mood stabilizers and for psychotic symptoms that may accompany depression.
The way in which atypical antipsychotics, also called atypical neuroleptics, work is not entirely understood. Atypical antipsychotics have a more far-reaching effect than the older antipsychotics. Like mood stabilizers, these medications seem to impact the body's neurotransmitters. One of the primary neurotransmitters is dopamine. It is thought that an excess production of dopamine can produce the kind of out-of-control, aggressive symptoms associated with ADHD or mood disorders. The most significant way in which atypical anti-psychotics is believed to act is by reducing the effects of dopamine by blocking some of the neuron receptors. (The newer atypical anti-psychotics also affect serotonin, as well as other neurotransmitters.) This results in a relatively quick way to create an internal balance and quell the most acute symptoms of bipolar disorder.
If your child's symptoms ever become so unmanageable that hospitalization becomes necessary, a short-term atypical antipsychotic will usually be used as a first line of treatment to reduce the most severe bipolar symptoms. Even though atypical antipsychotics are being prescribed to treat children and teens, there is still little research (and supporting data) about appropriate dosages, safety, side-effect issues, and how children respond to the medications. Just because a medication has been found to be relatively safe in treating adults, that does not mean it will have the same effect in kids. Still, it is common for these medications to be used as mood stabilizers for children and teens.
The U.S. Food and Drug Administration has set forth stringent standards for medications manufactured, labeled, and prescribed for use by children. Legislation known as the Best Pharmaceuticals for Children Act improves the safety and effectiveness of medications prescribed to children. You can review this legislation online at the FDA Web site (at www.fda.gov).