Antipsychotic Medications for Teens: Everything You Need to Know

Adolescence is a time of intense growth, emotions, and challenges — both for teens and for their families. However, when your teen is navigating what appears to be a serious mental health challenge, it can feel especially daunting. It’s normal to feel uncertain or unsure about what’s going on and how you can help.

At Mission Prep Healthcare, we realize how tough it can be to ask for help, openly discuss your fears and concerns, and talk about treatment options. But we also recognize taking that first step as an act of courage, and by connecting with our team, you can be assured of expert clinical care rooted in compassion and tailor-made treatment options.

When symptoms are serious, such as a disconnect from reality or severe mood disorders, among others, the topic of antipsychotic medications may come up in the conversation.  

The idea of antipsychotic medication for your teen can spark questions and concerns, often because of a lack of information. Learning all you need to know about antipsychotic medications can help you make informed choices about treatments that are right for your teen – and that’s why we’ve created this guide. It covers:

  • What antipsychotic medications are, their types, and how they work
  • The reasons why a teen may be prescribed antipsychotics
  • An overview of the most commonly prescribed antibiotics for teens
  • Their benefits, side effects, and other considerations
  • How long your teen may be expected to take antipsychotics
  • Alternative treatments to antipsychotics
  • The importance of involving family in treatment
  • Mission Prep’s approach to psychiatric medication for teens
  • How to get help for your teen today



Antipsychotic Medications for Teens

What Are Antipsychotic Medications?

Antipsychotics are psychiatric medications that were initially used to treat symptoms of a condition called “psychosis.” People with psychosis have difficulties staying in touch with reality and typically experience symptoms like delusions, hallucinations, uncoordinated speech, and disorganized behaviors. In other words, they can experience a range of negative symptoms that cause a decrease in the ability to function normally.¹

Different types of psychotic disorders exist, and schizophrenia and delusional disorder are some of the more well-known types. There is no one cause of psychosis, but it has been connected to the misuse of medications or substances. It could also occur because of the existence of another medical condition.² 

Antipsychotics have evolved since their original purpose, and are now used to treat other health conditions, where conventional treatments have proven ineffective, or no current treatment option exists. For instance, they can be used off-label for treatment-resistant depression, anxiety, and post-traumatic stress disorder (PTSD).

Therefore, a teen doesn’t necessarily need to have psychosis to be prescribed antipsychotic medication.

Types of Antipsychotics and How They Work

Antipsychotics act to change the way chemical messengers called “neurotransmitters” influence mood and behaviors. These medications are especially useful in conditions where symptoms include hallucinations, delusions, extreme mood swings, or severe aggression.

There are three major “classes” or types of antipsychotics, depending on when they were developed.³ 

Antipsychotics can be told apart by how they affect the brain in different ways and their potential side effects.

When Does a Teen Get Prescribed Antipsychotics?

Antipsychotics are not prescribed as a first-line treatment for most teen mental health conditions because of the potential for harmful side effects. Typically, the first approach is usually therapy, social skills training, and vocational therapy, as these are seen to have better outcomes overall.⁵ 

But, antipsychotics may be considered when other treatments haven’t worked, the condition is severe, or there is danger of a teen’s aggression causing harm to themselves or others.⁶ 

Psychiatrists are required to prescribe these medications only for the diagnosis they’re presented with. They also have to evaluate any risks and benefits, ensuring that the choice to take antipsychotics minimizes the risk of side effects. 

Additionally, parents and legal guardians should be made aware of the following before giving their teen the medication:
  • Reasons why the medication is being prescribed
  • Clinical evidence that supports its effectiveness
  • Potential side effects
  • How the doctor plans to monitor for problems with the medication, should they come up
  • How the doctor plans to reduce or stop the medication if it’s not achieving the expected effects or benefits 

Although many people assume that antipsychotics are only used to treat psychosis, they can also be used to manage the following conditions.

Common Conditions Treated by Antipsychotics

A teen may be commonly prescribed antipsychotics to treat:
  • Schizophrenia
  • Treatment-resistant depression
  • Autism
  • Tourette Syndrome
  • Autism spectrum disorder
  • Borderline personality disorder
  • Obsessive‐Compulsive Disorder (OCD)
  • Anorexia Nervosa
  • Insomnia
  • Delirium
  • Dementia syndromes, including Alzheimer’s disease
  • Behavioral disorders, such as Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD)

While the FDA has approved antipsychotic medicines for certain conditions, doctors may sometimes opt to prescribe a medication “off-label.” This means that they may opt to treat a condition with a medication that it’s not officially approved for use for. Typically, this happens when: 
  • There’s no approved drug available for a mental health condition
  • There’s a lack of success in treatment with other medications and treatments

Off-label usage, in these situations, is not considered illegal or unsafe. Your healthcare provider should cover how the medication is expected to work, as well as discuss any risks and benefits with you.⁸ 

What Is the Youngest Age for Antipsychotics?

Antipsychotics are not approved by the FDA for children under five years of age. However, they may be prescribed off-label when the situation requires.⁹ However, the likelihood of this is rare. These are powerful medications with the potential for adverse side effects in children, and there is a lack of clinical data to understand how they work in this age group. 

What Is the Safest Antipsychotic Drug for Children?

There’s no such thing as the “safest” antipsychotic across the board. Every teen is unique with different symptoms and physiological reactions. For this reason, psychiatrists usually prescribe medications based on your teen’s diagnosis, medical history, severity of symptoms, and risk of side effects. Discuss the options with your doctor, so you can make an informed decision on your child’s treatment.

However, in general, out of the approved list of antipsychotics, Risperidone and Aripiprazole are considered the better-tolerated antipsychotics.¹¹ 

Commonly Prescribed Antipsychotics for Teens

If you’re considering antipsychotics for your teen, you may come across a variety of different names and brands. Yet, currently, the FDA has approved only the following 6 antipsychotics for teens. These include:¹º 
  • Asenapine (Saphris, Secuado)
  • Paliperidone (Invega)

Depending on the specific medication, these are approved for use in conditions such as schizophrenia, bipolar disorder, irritability in autism spectrum disorder (ASD), and Tourette’s syndrome.

Benefits of Antipsychotic Treatment in Teens

Considering antipsychotics can be scary – especially when you’re confronted with a list of frightening side effects. However, rest assured that a provider wouldn’t consider them unless they came with potential benefits. Antipsychotic medications can have significant positive effects when used appropriately. For instance, they can:
  • Stabilize mood and behavior in conditions like schizophrenia and bipolar disorder. ¹²
  • Improve quality of life. This means that a teen can feel more fulfilled in how they reach personal goals, live up to expectations, and function in daily life.¹³ 
  • Calm aggressive behaviors and improve sleep quality¹⁴ 
  • Reduce self-harming thoughts and behaviors¹⁵ 

In other words, when combined with therapy and support, antipsychotics can create a stable foundation for recovery. However, this doesn’t mean they don’t come with a risk of potential side effects. Let’s cover these risks next. 

Side Effects of Antipsychotics in Adolescents

Although antipsychotics may be beneficial in the treatment of some conditions, they are not without risks, especially for young people. Depending on the medication and the teen, side effects may include:¹⁶
  • Sleepiness or drowsiness
  • Uncontrollable movements, like tics and tremors
  • Dizziness
  • Headaches
  • Dry mouth 
  • Increased heartbeat
  • Sensitivity to the sun
  • Skin rashes

There may also be an increased risk of weight gain with antipsychotics in teens. Other potential side effects include:  
  • High cholesterol or triglycerides
  • High blood sugar levels and risk of diabetes
  • Increase in the production of a hormone called “prolactin,” which is associated with abnormal breast development in boys and girls, and atypical monthly periods. It can also stop periods altogether while taking the drug
  • Neuroleptic Malignant Syndrome; a rare, life-threatening condition that includes high fever, sweating, variations in blood pressure, and muscle stiffness. The risk of this is low
  • Suicidal thoughts in children, especially with the antipsychotics Aripiprazole and Quetiapine. 

In terms of the long-term effects of antipsychotics in adolescents, there may be an increased risk of developing a condition called “Tardive Dyskinesia,” which can cause uncontrollable muscle movements.

Your provider can discuss how they plan to monitor and plan for side effects. So, if you’re concerned about these risks, talking with them about any potential benefits and side effects can put your worries at ease.
At Mission Prep, for example, we use stringent protocols to monitor each teen and make sure treatment is both working and safe.

How Long Will a Teen Need to Take Antipsychotics?

How long a teen needs to take antipsychotics can vary from person to person, hence there isn’t any black and white answer to this question. Your doctor will evaluate the most appropriate medication for your teen, considering factors such as their condition, severity of symptoms, treatment response, other medical conditions (if any), and potential side effects. Based on this evaluation, they may be able to give you a rough outline, but they will also let you know that this can change depending on the response to treatment. 

As an important note, stopping antipsychotics safely requires a tapered approach and medical supervision. Coming off antipsychotics suddenly could cause a relapse of symptoms. Mission Prep can help you create a tapering plan for your teen.

Alternatives and Complementary Treatments

Antipsychotics are not the first-line treatment option for mental health conditions unless other treatment options have been exhausted, no other treatment options exist, or there’s a danger of imminent harm. Your provider will likely consider other therapeutic and complementary treatment options first, including:

Psychotherapy or talk therapy:

Talk therapy options include cognitive-behavioral therapy (CBT) and EMDR therapy.

Mindfulness and relaxation training:

These techniques aim to reduce symptoms of anxiety and improve the ability to regulate emotions.

Teen Transcranial Magnetic Stimulation:

A non-invasive treatment where magnetic fields are used to activate specific parts of the brain. It’s primarily used to treat conditions like depression, anxiety, OCD, and PTSD, when other treatments haven’t yielded results.

Involvement of the Whole Family in Treatment

At Mission Prep, we adopt a whole-family approach, where family is integrated into the treatment program. We believe that loved ones are vital to creating a long-term and sustainable recovery for adolescents. For instance, through our unique and comprehensive approach, we:
  • Involve families in all aspects of treatment planning
  • Provide family therapy and psychoeducation, where family members are given information on a teen’s condition and how they can manage it better within the home and community 
  • Ensure both teens and families receive skills training on critical topics for recovery, such as communication, setting appropriate boundaries, and emotional regulation

Family involvement in treatment has been shown to improve outcomes, so don’t hesitate to reach out for more information on how you can advocate for your teen’s well-being.

Mission Prep’s Approach to Psychiatric Medication for Teens

At Mission Prep, we offer expert clinical support to teens and their families throughout their treatment program, from onboarding to final discharge and reintegration into the community. 

When antipsychotic medications are part of the treatment plan, as part of our mission to provide quality, evidence-based care, we provide:
  • Board-certified psychiatrists evaluate and prescribe medications based on each teen’s needs, track progress, and monitor side effects
  • A safe, home-like environment that focuses on providing compassionate care to promote healing
  • Opportunities to involve family in all aspects of treatment planning and care 

Our treatment packages include
residential, outpatient, and telehealth services, so that your teen has continued support at every stage of their recovery journey. 
Antipsychotic medications for teens

seek mission prep for comprehensive and compassionate adolescent care

Dealing with mental health challenges can be overwhelming, especially when the option of antipsychotics is being considered. But you don’t have to cope alone – help is on hand.

If your teen is struggling with a mental health condition, and you’re exploring treatment options, especially those that potentially need medication, consider Mission Prep. We provide evidence-based treatment programs, a caring medical team, and a holistic approach to healing. 

Connect with us today at (866) 451-1973 or simply fill out our contact form to learn more about how we can support your teen’s journey to a fulfilled life and mental well-being.

References

  1. National Center for Biotechnology Information. (2023, May 1). Psychosis. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK546579/
  2. National Center for Biotechnology Information. (n.d.). Table 3.20, DSM-IV to DSM-5 psychotic disorders – Impact of the DSM-IV to DSM-5 changes on the National Survey on Drug Use and Health. NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t20/
  3. National Center for Biotechnology Information. (2023, February 26). Antipsychotic medications. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK519503/
  4. National Center for Biotechnology Information. (n.d.). Introduction – First-generation versus second-generation antipsychotics in adults: Comparative effectiveness. NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK107237/
  5. Agency for Healthcare Research and Quality. (n.d.). Safe and judicious use of antipsychotic medications in children and adolescents toolkit. https://www.ahrq.gov/pqmp/implementation-qi/toolkit/antipsychotic/overview.html
  6. New York State Office of Mental Health. (n.d.). Clinical advisory regarding the use of atypical antipsychotic medication in children and adolescents. https://omh.ny.gov/omhweb/sga_advisory/advisory.html
  7. Stroup, T. S., & Gray, N. (2018). Management of common adverse effects of antipsychotic medications. World psychiatry : official journal of the World Psychiatric Association (WPA), 17(3), 341–356. https://doi.org/10.1002/wps.20567
  8. Understanding unapproved use of approved drugs “off label”. (2018, February 5). U.S. Food and Drug Administration. https://www.fda.gov/patients/learn-about-expanded-access-and-other-treatment-options/understanding-unapproved-use-approved-drugs-label
  9. Centers for Medicare & Medicaid Services | CMS. (n.d.). Centers for Medicare & Medicaid Services. https://www.cms.gov/medicare-medicaid-coordination/fraud-prevention/medicaid-integrity-education/pharmacy-education-materials/downloads/atyp-antipsych-pediatric-factsheet11-14.pdf
  10. Centers for Medicare & Medicaid Services | CMS. (n.d.). Centers for Medicare & Medicaid Services. https://www.cms.gov/medicare-medicaid-coordination/fraud-prevention/medicaid-integrity-education/pharmacy-education-materials/downloads/atyp-antipsych-pediatric-factsheet11-14.pdf
  11. Cicala, G., Barbieri, M. A., Santoro, V., Tata, C., Colucci, P. V., Vanadia, F., Drago, F., Russo, C., Cutroneo, P. M., Gagliano, A., Spina, E., & Germanò, E. (2020). Safety and Tolerability of Antipsychotic Drugs in Pediatric Patients: Data From a 1-Year Naturalistic Study. Frontiers in psychiatry, 11, 152. https://doi.org/10.3389/fpsyt.2020.00152
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  13. Sampogna, G., Di Vincenzo, M., Giuliani, L., Menculini, G., Mancuso, E., Arsenio, E., Cipolla, S., Della Rocca, B., Martiadis, V., Signorelli, M. S., & Fiorillo, A. (2023). A Systematic Review on the Effectiveness of Antipsychotic Drugs on the Quality of Life of Patients with Schizophrenia. Brain sciences, 13(11), 1577. https://doi.org/10.3390/brainsci13111577
  14. Golubchik, P., Sever, J., & Weizman, A. (2011). Low-dose quetiapine for adolescents with autistic spectrum disorder and aggressive behavior: open-label trial. Clinical neuropharmacology, 34(6), 216–219. https://doi.org/10.1097/WNF.0b013e31823349ac
  15. Huang, X., Harris, L. M., Funsch, K. M., Fox, K. R., & Ribeiro, J. D. (2022). Efficacy of psychotropic medications on suicide and self-injury: a meta-analysis of randomized controlled trials. Translational psychiatry, 12(1), 400. https://doi.org/10.1038/s41398-022-02173-9
  16. CHIP. (n.d.). Antipsychotic medicines for children and teens. https://chip.wv.gov/SiteCollectionDocuments/Antipsychotic%20Medicines%20for%20Children%20%20Teens.pdf