by Timothy E. Wilens
Review by Stephanie Sarkis,Ph.D. on Dec 15th 2009
Dr. Timothy Wilens is an associate professor of psychiatry at Harvard Medical School, and specializes in pediatric and adult psychopharmacology at Massachusetts General Hospital. Dr. Wilens has published prolifically on child and adolescent psychiatric issues. Straight talk about psychiatric medications for kids is divided into three parts. Part I, "What every parent should know about psychiatric medications for children", contains four chapters. This includes Chapter 3, "The diagnosis and treatment plan: laying out a strategy to help your child"; and Chapter 4, "Treatment and beyond: Collaborating in your child's ongoing care." Part II, "Common Childhood Psychiatric Disorders" contains seven chapters, including Chapter 5, "Attentional and Disruptive Behavioral Disorders"; Chapter 9, "Schizophrenia and Other Psychotic Disorders"; and Chapter 10, "Disorders of Known Medical and Neurological Origin".
Part III, "The Psychotropic Medications", contains seven chapters, including Chapter 12, "The Stimulants and Nonstimluants for ADHD"; Chapter 15, "The Anxiety-Breaking Medications"; and Chapter 16, "The Antihypertensives". The book also contains an Appendix, "Representative Medication Preparations and Sizes Used for the Treatment of Childhood Emotional and Behavioral Disorders". The Appendix contains a table with information on the generic and brand names of medication, along with each medication's dosages and form (i.e. tablets, skin patch). The appendix also has a "Medication Log", which provides spaces for the start/end date of a medication, the name of the medication, the daily dose, the response (ie. "good", "very good", "excellent"), the side effects experienced, and comments, such as "good school performance", "good behavior", and "attention problems". There is an example of a completed Medication Log, and a blank Log for photocopying.
The book also contains a Resources section. The information in this section is divided by disorders. In addition, there is a Bibliography, also divided by disorders. This creates more ease of use for parents discovering resources for their child's condition.
The book is written for parents of children who may be taking or are currently prescribed psychotropic medication. The book is written at a level that is understandable and respectful to parents. Even the chapter titles are written in user-friendly language. Instead of titling a chapter "Anxiolytic Medications", Wilens has titled it "The Anxiety-Breaking Medications". This gets the same point across without having to use a dictionary to find out what "anxiolytic" means. The book is written in second person, thus directly addressing the parents. This makes the book more personable and accessible.
In Chapter 3, "The Diagnosis and Treatment Plan: Laying out a strategy to help your child", Wilens writes, "You should agree to treatment only if you are satisfied that the practitioner understands your child and your concerns and has accurately assessed the problems" (p. 81). Wilens writes that "leaving your child untreated for a short period is unlikely to have any harmful effect" (p. 83, italics as per the book). Wilens' view that the parent is the expert on the child is empowering for the parents and helps them advocate for their child. Wilens recommends that parents speak with their child's doctor about their concerns, and also do some "independent research", such as obtaining information from the American Academy of Pediatrics, the American Association of Child and Adolescent Psychiatry, contacting support groups, or the resources listed at the end of the book. Wilens writes that doing "independent research" results in one of three options: the doctor's recommendation is confirmed; the parents will find alternatives that can be discussed with the doctor; or the information will help the parents ask questions in order to gain more information from the doctor. Wilens presents questions that parents commonly ask, such as "When should we consider getting a second opinion?" (p. 84). In answering this question, Wilens writes that if a parent does seek a second opinion, the child should be reevaluated instead of having the second opinion doctor review the report from the first doctor.
Chapter 5, "Attentional and Disruptive Behavioral Disorders", Wilens discusses Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD). Wilens describes the role of acetylcholine and nicotine in ADHD in a very understandable way. He also writes about the parts of the brain affected by ADHD, and the fact that brain activity and brain imaging is "not considered reliable or valid in diagnosing ADHD; nor are blood tests" (Wilens, p. 147). The chapter includes a table of medications prescribed for ADHD, ODD, and CD.
Chapter 9, "Schizophrenia and Other Psychotic Disorders", Wilens begins the chapter by defining psychosis, delusions, and hallucinations, and states that "your child should not be diagnosed as psychotic unless the boy or girl has either delusions or hallucinations" (Wilens, p. 183). Wilens also points out that children may not tell their parents about their delusions or hallucinations. Usually it is other severe behavior issues that first become apparent. The chapter includes table of medications prescribed for schizophrenia and psychotic disorders. The table not only lists atypical and older antipsychotics, but also lists medications that may be added to antipsychotics if there are mood swings, severe outburst, or anxiety present in addition to the psychotic disorder.
Chapter 16, "The Antihypertensives", discusses clonidine, guanfacine, and propranolol, medications which are used to treat high blood pressure in adults. However, they are also prescribed for ADHD, tic disorders, autism, and sleep difficulties. Wilens details each medication, providing the generic and brand names, dosages, and how the medication is available (tablets or patch). He also gives the possible side effects of the medications. Wilens also defines terms such as "adrenergic nervous system" in a way that is user-friendly and understandable.
Straight talk about psychiatric medications for kids is one of the definitive books on pediatric psychopharmacology. It is an additional bonus that it is written specifically for parents. Straight talk about psychiatric medications for kids is highly recommended for clinicians and parents alike.
© 2009 Stephanie Sarkis
Stephanie Sarkis PhD is the author of three books: 10 Simple Solutions to Adult ADD: How to Overcome Chronic Distraction & Accomplish Your Goals (2006); Making the Grade with ADD: A Student's Guide to Succeeding in College with Attention Deficit Disorder (2008); and ADD and Your Money: A Guide to Personal Finance for Adults with Attention Deficit Disorder (2009). Dr. Sarkis is a National Certified Counselor (NCC) and Licensed Mental Health Counselor (LMHC) based in Boca Raton, Florida. She provides counseling and coaching to children and adults with ADHD/ADD. She is also an adjunct assistant professor in Counselor Education at Florida Atlantic University.