The process of prescribing psychiatric medication in child and adolescent psychiatry consists of the following steps:

  1. Specialist assessment and diagnosis: Medication may only be prescribed by a specialist child and adolescent psychiatrist. The process begins with a comprehensive psychiatric assessment, during which the clinician evaluates the child’s mental state, symptoms, family and school environment, and medical history. If necessary, physical, neurological, laboratory, and imaging investigations may also be carried out in order to rule out organic causes. The diagnosis is made based on the individual presentation, clinical symptoms, and internationally recognised diagnostic criteria. According to both national and international guidelines, non-pharmacological interventions – such as psychotherapy or developmental interventions – form the cornerstone of treatment in most child and adolescent psychiatric conditions. For this reason, medication is not typically recommended as a standalone treatment.

  2. Treatment planning: Following diagnosis, and in consultation with the diagnostic team where applicable, the child and adolescent psychiatrist develops an individualised treatment plan. This may include pharmacological treatment, psychotherapy (e.g. MBT, CBT, art therapy, play therapy or family interventions), lifestyle modifications, and, where necessary, the involvement of other professionals (e.g. clinical psychologists, special educational needs teachers). Medication is generally used as an adjunct to psychotherapeutic work rather than as a stand-alone intervention. At Murmo, we do not provide purely pharmacological treatment.

  3. Medication prescription and consultation: If the specialist considers medication to be indicated, they provide detailed information to the parents or legal guardians (and to the child, in an age-appropriate manner) regarding the recommended medication, its mechanism of action, potential side effects, dosage, and expected duration of treatment. Where the child or adolescent is engaged in an ongoing therapeutic process, the prescribing clinician also consults with the treating team. Shared decision-making and parental consent are essential.

  4. E-prescription: Medication is typically prescribed electronically via the EESZT (Hungary’s Electronic Health Service Space) system. This allows remote prescribing and enables dispensing in community pharmacies.

  5. Dispensing medication: E-prescriptions can be filled at any pharmacy upon presentation of the child’s social security (TAJ) number and verification of the identity of the person collecting the medication. It is important to note that for strictly controlled medications (e.g. Ritalin), dispensing is only possible at a designated pharmacy with a separate pharmacy notification. In the case of Ritalin treatment, the e-prescription is valid for five days.

  6. Monitoring (follow-up appointments): Following the initiation of medication, regular follow-up appointments are required. During these consultations, the psychiatrist assesses treatment efficacy, monitors possible side effects, and adjusts dosage or medication type if necessary. The aim of follow-up is the continuous optimisation of the child’s condition and ensuring their safety. At Murmo, this process is carried out in accordance with the principle of extended confidentiality, in collaboration with the wider treatment team.

It is important that during psychiatric pharmacological treatment, parents actively cooperate with the specialist and communicate openly about the child’s condition, the effects of the medication, and any emerging concerns. If this does not occur, we are unable to take responsibility for the effectiveness of the pharmacological treatment.

Relevant sources