Exploring the Benefits of Medication for Oppositional Defiant Disorder (ODD)

Oppositional Defiant Disorder (ODD) falls under the category of disruptive, impulsive control, and behavior disorders. ODD is characterized by patterns of defiant, hostile, or disobedient behavior that is not appropriate for one’s developmental stage. 

You can identify ODD through the following symptoms:

• Frequent loss of temper
• Being “touchy” or easily annoyed often
• Is often angry or resentful
• Arguing with authority figures often (or, for kids and teens, arguing with adults)
• Actively defying or refusing to comply with requests and rules from authority figures
• Deliberately bothering or annoying others often
• Blaming others for one’s behavior or mistakes often
• Spiteful or vindictive actions

Medication is not the first recommended treatment for ODD. However, medication can be necessary when other treatments don’t work independently. 

This article will go over the benefits and types of medication for ODD, considerations for medication treatment, including the importance of combining medication with other interventions, and how Joon can help. 

Benefits of Medication for ODD

Kids with ODD might experience a range of internal and external symptoms that impact their quality of life, family relationships, and social relationships. Different psychiatric medications can support kids with ODD in various ways, including the following. 

Reduction of defiant and disruptive behaviors

Aggression is one of the main symptoms kids with ODD experience. Research suggests that medications like Risperidone can lead to reduced aggression and conduct problems in kids with a disruptive behavior disorder diagnosis.

Improvement in emotional regulation

Children with ODD often struggle with emotion regulation, poor tolerance for frustration, and intensified emotional reactivity. Emotion regulation is often at the core of ODD symptoms. Medication can help stabilize emotions in kids with ODD, leading to lower levels of potentially disruptive reactivity and an increased ability to engage in and enjoy daily life.

Enhancing social interactions and relationships

Stabilized emotions from the right combination of treatments can enhance social interactions and relationships. Kids with ODD often have trouble making and keeping friends and have negative social interactions in various parts of life, including at home, in education, and in other settings. When it's treated, and impulsivity and emotions are better managed, children can experience an increased ability to play with other kids successfully, positive experiences at school, and an overall easier time interacting with others.

Increased quality of life, both short and long-term

Adolescents and adults who have been diagnosed with ODD have a 90% chance of being diagnosed with another mental health condition at some point in their life. Anxiety disorders, mood disorders, substance abuse, conduct disorders, and personality disorders are all common diagnoses that occur later on. According to the AACAP, kids who do not get treatment for ODD are at a higher risk of substance use disorders and delinquency.

Early symptom management can help children with a behavior disorder have more positive childhood experiences. When combined with other treatment options, like behavior modification techniques taught in parent management training, kids get a stronger foundation for a better quality of life later on. Medication can also help children with school performance and compliance in therapy, at home, or at school.

Types of Medications Used for Treating ODD

The best medication for your child with ODD may differ based on various factors. Here are the most common medications used for kids with ODD and why each one can be helpful or might be prescribed to your child. 

Stimulant medications

ODD is one of the conditions most likely to co-occur with attention deficit hyperactivity disorder (ADHD). If a child has both ADHD and ODD, it is crucial that ADHD symptoms are addressed. When ADHD is treated, it causes less frustration and overall difficulty for the child, which can lead to better-managed ODD symptoms. Stimulant medications are the first line of medication treatment for ADHD symptoms. Adderall, Ritalin, Concerta, and Vyvanse are common examples.

Antidepressants

Antidepressants are used for a variety of mental health problems and even some physical health conditions. One study found that fluoxetine (Prozac), especially when combined with cognitive behavioral therapy, helped adolescents ages 12-17 with a primary diagnosis of depression reduce oppositional behaviors more than therapy alone. It is important to note, however, that the impact of Prozac on oppositional behaviors has not been evaluated by the FDA and use of this medication to treat such behavior would be considered “off-label” and at the discretion of a prescribing physician.

Antipsychotic medications

Atypical antipsychotics are a newer type of antipsychotic medication. The most common antipsychotic medications used for a disruptive behavior diagnosis in kids are Risperidone (Risperdal), Geodon, and Abilify. An open-label trial in kids and adolescents with conduct disorder, ADHD, and ODD, found that using low-dose risperidone led to a decrease in ADHD, ODD, and conduct disorder symptoms in most participants. Similar to antidepressants, however, these have not been FDA approved for use in children with ODD.

Mood stabilizers

Mood stabilizers can help kids with disruptive behavior disorders regulate reactivity and mood. Anticonvulsant medications like Depakote are often used as mood stabilizers, and many of them are approved by the FDA to treat specific mental health disorder diagnoses, like manic episodes in Bipolar disorder. As a result, this is one of the mood stabilizers a physician may prescribe a child off-label in order to help with the treatment of a disruptive behavior disorder.

How Joon Can Help

Joon is an app designed for kids aged 6-12+ with ADHD, Autism, ODD, and related conditions or behavioral health concerns. Using Joon supports behavior management, self-esteem, and task completion and initiation in kids.

Parents sign up first by downloading the Joon Parent App and creating a task list for their child. Common tasks or “quests” include household chores, homework, and other parts of a child’s daily routine. When kids complete a quest, they get rewards in Joon Pet Game that allow them to care for a virtual pet called a Doter and continue playing. 

90% of kids who use Joon finish all of their tasks, and many families say it’s improved their parent-child relationship.

Click here to try Joon today.

Considerations for Medication Treatment

All kids will have different responses to medication, and their full treatment plan might differ based on their specific needs, concurrent diagnoses, or experiences. As your child starts, continues, or gets ready to change medications for ODD and related mental health conditions, here are some things to consider. 

Consultation with a mental health professional

Consulting with a mental health provider will help you determine the right treatment plan for your unique child. Various risk factors are connected to the development of ODD, including trauma and family history. When kids with ODD have been through one or more traumatic events, it’s important that trauma is addressed as an underlying factor.

Monitoring for side effects and effectiveness

Your child's prescriber should go over medication side effects with you and it is important to ask them what evidence supports the use of this medication for your child’s behavior. Watch your child for new physical or mental and emotional side effects, and talk with your child's healthcare provider if you notice anything of concern.

Most medications - specifically, mood stabilizers, antidepressants, and antipsychotics, in this case - take a certain amount of time to start working. For example, a new antidepressant may take 6-8 weeks to work.

Stimulant medications for ADHD are often fast-acting, but some types of ADHD medication (namely, Strattera, which can take 8-12 weeks) take more time to start working.

Adjusting medication dosage and type as needed

Children's symptoms often change as they grow. Children will sometimes need a higher medication dose as they age. Or, due to changes in symptoms and diagnosis, they might start to benefit more from a different medication entirely.

Here are some of the factors that might call for a change in medication type or dose:

• Age and development
• Symptom or diagnostic changes
• Side effects

When a child first starts medication, prescribers often start with a very low dose and move up slowly until it is most therapeutic in order to avoid excessive side effects. Some medications will also work well for kids at a very low dose.

Importance of combining medication with therapy and other interventions

Medication can be a game-changer. However, medication and therapy play different roles in helping kids with ODD. Ideally, evidence-based therapies and related treatment options for problem behaviors and other symptoms will be combined with medication for the most effective treatment plan.

Parent management training is the main treatment for kids with ODD. Parent training programs work by teaching caregivers skills and techniques to use at home that decrease defiant behavior and increase positive interactions. 

Individual therapy can also be valuable for kids with behavior problems. Mental health professionals who work with ODD in kids use child-friendly approaches. Common modalities include cognitive behavioral therapy, dialectical behavior therapy, and social skills training.

In some cases, family therapy can be helpful. In family therapy, family members attend sessions together as a unit, and the therapist serves as an objective third party. Family therapy can support communication and understanding within the family or household.

Conclusion

Medication can be an important part of ODD treatment, especially for children with comorbid ADHD or other disorders. Every child with ODD is different, and there are multiple risk factors that can increase the likelihood of ODD. Kids with any type of disruptive behavior disorders can get to a better place, where problem behaviors are managed or reduced. Treating ODD can also decrease risks like the development of substance use disorders later in life.

Patience and consistency from parents, support for co-occurring disorders, parent and child training or behavioral therapy, and, if applicable, medication can all play vital roles in helping kids or teens with ODD. Since every child with an ODD diagnosis is unique, it is critical that their treatment plan is customized to fit their unique needs.

ODD can be challenging for parents to navigate. Seeking help for oppositional behavior and using evidence-based ODD treatment methods and parenting techniques can change the course of a child's life for the better and decrease parental distress.