When your child brings home a note from his teacher that he is having problems in school, how do you make sure you are addressing the real cause? Of course, you’ll make sure your child is getting enough sleep and eating properly. But there are other reasons behind poor school performance that you may not know about.

Medicines That Can Cause Sleepiness

One reason behind poor school performance is that your child is too sleepy to pay attention or participate in activities. If your child is taking any medicines, talk to your pediatrician. Common medicines that can cause sleepiness are antihistamines, migraine medicines and antidepressants.

Many children take antihistamines for allergies or hives. There are two types of antihistamines: first-generation and second-generation. First-generation antihistamines have been available for a long time and are more likely to make your child feel sleepy or groggy. In fact, several first-generation antihistamines are used as the main ingredient in sleep aids. For example, the main ingredient in Benadryl Allergy and Simply Sleep is the same. Second generation antihistamines are newer and are less likely to have that side effect. You can buy both types without a prescription, or “over the counter” (OTC).

According to Dr. Goddy T. Corpuz, a pediatrician in Cedar Park, “Some OTC antihistamines definitely can cause drowsiness. Many people are not aware that most OTC cough and cold medicines, including Nyquil, contain second-generation antihistamines, such as chlorpheniramine or doxylamine. In higher doses, these drugs can cause respiratory depression in children. That’s why they have those warning labels not to administer and to ask a doctor first, particularly in infants and younger children.”

“If your child has a cough or a cold, try a saline nasal spray or a humidifier,” says Dr. Corpuz. “There’s no scientific evidence that cough and cold medications help.”

“Another commonly prescribed antihistamine that can cause drowsiness is cyproheptadine,” says Dr. Corpuz. “It was originally marketed for migraines. We still use it for that, but now it is more commonly prescribed as an appetite stimulant.”

“Antidepressants and seizure medicines also can have a sedative effect,” says Dr. Corpuz. Common antidepressants are fluoxetine and sertraline. Common seizure medicines are phenobarbital, fosphenytoin and oxcarbazepine.”

Talk to your child’s pediatrician about problems with drowsiness. See the sidebar “Common Medicines That Can Cause Sleepiness” for a list of medicines that may make your child sleepy. “Substitutions can be made whenever side effects are debilitating,” says Dr. Corpuz.

Medicines That Can Make Your Child Grumpy or “Hyper”

Another reason behind poor school performance is “bad behavior.” Parents may not consider that the root of the problem could be a medicine the child is taking. Some medicines can cause your child to be really grumpy or “hyper.”

“Believe it or not, antihistamines in a few children can have the opposite effect of drowsiness—they can cause irritability and excitability,” says Dr. Corpuz. “You may describe this as your child acting ‘hyper’.”

He goes on to say, “Sometimes, children labeled as having bad behavior may have undiagnosed attention deficit hyperactivity disorders (ADHD) or sleep disorders. We know that children with sleep apnea can present with excessive daytime drowsiness, but some may have hyperactivity. Pseudoephedrine (Sudafed), a cough medicine ingredient, can cause sleep problems, excitability, nervousness and hallucinations in children.”

“Patients who do not have ADHD but are taking ADHD stimulant medicines may have irritability and excitability or the opposite,” Dr. Corpuz warns. One example of this is a college student who is experimenting with ways to study more effectively for exams.

Social Issues and Poor Performance in School

The third reason your child may be doing poorly in school is an unidentified medical condition. “The most common unidentified medical condition that results in social issues or poor performance is ADHD,” says Dr. Corpuz. Children with ADHD often display:

• Difficulty paying attention

• Trouble controlling their behavior

• Overexcited or “hyper” behavior

It’s important that children with possible ADHD be identified. According to the CDC, fewer than 1 in 3 children between the ages of 6 to 17 who have ADHD get proper treatment with both medication and behavior therapy.

Common Meds That Can Cause Sleepiness

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Brenda Schoolfield is a freelance medical writer in Austin.


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