SAN FRANCISCO, Sept. 8 (UPI) -- When a child has been properly diagnosed with depression and non-drug options ruled out, parents should not be afraid to pepper the physician with questions before agreeing to a pharmaceutical course of treatment, specialists advise.
The series of recent black eyes handed the medical establishment -- from the withdrawal of the painkiller Vioxx from the market for safety reasons to the affixing of warnings of suicidal behaviors in some users on anti-depressant labels -- has played into parents' hands, placing them in a particularly strong decision-making position of which they should take advantage, experts say.
"The power relationship between the medical profession and patients and parents may be shifting because of all those tragedies," said researcher, author and clinical psychologist Tamar Chansky.
Chansky, director of the Children's Center for OCD (Obsessive-Compulsive Disorder) and Anxiety in Plymouth Meeting, Pa., has written "Freeing Your Child from Anxiety" (Broadway Books, 2004) and "Freeing Your Child from Obsessive-Compulsive Disorder" (Crown Publishers, 2000).
"The best thing to come out of the Vioxx/antidepressant tragedies, given all the press, would be that parents will be more concerned with safety, that they will feel they have the right to get more information from the medical professional, and more information is never a bad thing," he said.
Before their interview with the physician, Chansky advises children's caretakers to visit the library or reputable Web sites, such as those of the American Pediatric Association or the American Psychiatric Association.
"The most important thing is to be informed," he said.
"Come in with a printout and say, 'What can we do to make this work?' Ask about the safety issues related to the medication. What should I expect to see in my child? What are the expected reactions? What should I watch for that would be a sign of a problem?" Chansky recommended.
"Parents should ask about changes that occur with SSRIs," he advised. "The child may be more sleepy or more energized. 'How do I differentiate a normal reaction (to the medication) from my child becoming ... suicidal?' When the doctor meets with the child even for 20 minutes, he should be able to answer these questions."
Once treatment starts, parents should be ready to seek additional professional input if they're not seeing the anticipated improvement in their child, specialists say.
"If the child is not getting better, and the doctor runs out of ideas or if the doctor is seeing progress but the parents do not feel that way, they should get a second opinion," Chansky advised.
"Also, part of informed consent is knowing how you go off the medication, and not all doctors talk about that," he added. "Consult your doctor when you're going to discontinue the child's medication. Children are getting very sick from getting off the meds too quickly."
Parents must educate themselves on what's at stake and advocate for their child, urged James Maddux, a clinical child psychologist at George Mason University in Fairfax, Va., who specializes in cognitive-behavior therapy.
"I hope that people will start to ask more questions. I hope they'll start asking whether we're overmedicating, overprescribing for our children's psychological problems," he said.
"It's not a matter of not trusting the medical profession or mental-health professional but a matter of realizing in many cases the science is just not there and even well-intended people can make errors in judgment, and the best protection is to be a well-informed consumer."
(Editors' Note: This series on depression is based on a review of hundreds of reports and a survey of more than 200 specialists.)
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UPI Consumer Health welcomes comments on this column. E-mail Lidia Wasowicz at [email protected]
