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Making sense of anxiety meds for teens: Which is right for your child?

First of all, anxiety can come in many forms, and there are several types of anxiety your teen may face. But once your child is diagnosed with anxiety, you may be faced with a decision: ‘talk’ therapy, medication, or both? If you go with the ‘both’ option, your next question will be: which anxiety meds for teens is the ‘right’ one?

The first thing you’ll probably learn: there may not be one ‘right’ one. Instead, you may find yourselves trying several, making adjustments to dosage, and trying another. And sometimes yet another. It can be a frustrating process, and can cause some very real hurdles for your teen. For instance, my teen tried an anxiety medication that made him so tired, he missed the entire next day of school, missing a big test. Then, on top of dealing with anxiety and finding the right meds, he was behind in school.

Tip: while your teen is figuring out which anxiety meds and dosage is right for them, ask your psychiatrist or doctor for a letter of accommodations for school. This letter is usually sent directly from your doctor or therapist’s office to your child’s school counselor or teacher, and asks for a specific accommodation, such as more time to make up schoolwork for a finite amount of time or fewer assignments while they sort out their meds. These types of accommodations are covered under the American Disability Act, so don’t be afraid to ask for them!

Common anxiety meds for teens:

Buspirone: Buspirone is used to treat both short-term anxiety and chronic (long-lasting) anxiety disorders. It’s important to note that Buspirone can take up to several weeks to become fully effective, so this is not an ’emergency’ med your teen would only take occasionally.

Fluoxetine and Sertraline: These selective serotonin reuptake inhibitors (SSRIs) work by increasing levels of serotonin, which affects mood, sexual desire, appetite, sleep, and memory. You may be more familiar with their brand names, Prozac and Zoloft. SSRIs are typically started at a low dose, and they can also help treat depression. Teens are often prescribed Prozac because this med is less addictive and teens cannot overdose.

Clomipramine and imipramine: Similar to SSRIs, these meds are known as Tricyclics, and they treat anxiety disorders with the exception of OCD. They are older meds that aren’t used as often anymore for teens.

Isocarboxazid and Phenelzine: These MAOIs (monoamine oxidase inhibitors) treat panic disorder and sometimes social phobia. They increase the number of neurotransmitters that regulate mood.

Note about benzodiazepines: Benzodiazepines are sedatives and work by increasing the effects of certain neurotransmitters in the brain. Because they can be addictive, they are rarely prescribed to teens. Some exceptions: Lorazepam, which is the generic version of Ativan, is sometimes prescribed. Lorazapam can cause extreme drowsiness in some teens, and sleeplessness in others. It is an experiment to see what works, unfortunately.

Making a game plan for finding the right anxiety meds for teens:

So how do you go about figuring out which of these options (and there are more, too!) will work best for your teen? It’s crucial to have a good working relationship with your child’s psychiatrist or psychiatric RN (or whatever MD is prescribing meds to your teen). You will need to work together to find the right one. Ask if you can sit in on some of your child’s sessions, or even just part of a session, with your teen’s permission, so you can share your observations with the medication professional.

For example, my teen sometimes downplayed the side effects of his meds to his psychiatrist or failed to make the connection between sleeplessness and his meds, or over-stimulation and his meds. He and his doctor have the final say, but I was able to add insight that he did not think to share.

Keep a medication log with your teen, so you can track changes and side effects over a period of time. My teen and I also implement an even simpler system of ‘rating’ each day on a scale of 1-100. This log gives us a good overview of how his meds are helping (or not) over a time period of weeks or months.

Remember that it’s also crucial to continue therapy or behavioral therapy with your teen in addition to meds, should you decide that meds are right for your teen.

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Anxiety meds for teens: how to know what's right for your child.

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