Medication and Prescription Considerations

Many individuals with Down syndrome acquire multiple doctors and specialists. While it is common for several doctors to be involved in prescribing medications for one individual, they may not be communicating with one another at all. It is important to be proactive with management of the medication list, making sure that both prescriptions and over-the-counter drugs, along with their doses and frequencies, are up to date.
As a general rule, it is advisable to start new medications at a low dose and slowly increase them if necessary. Be sure to understand why a medication is being recommended and inquire about side effects. Avoid making multiple medication changes at once or starting or adjusting two medications at the same time. Changing or adding one thing at a time allows for a clearer picture of the impact of the medication on its own. All medications, including over-the-counter and herbal medications, should be periodically reviewed, especially with the primary care doctor at times of transition (leaving the hospital, transferring to a new living situation, etc.).
During reviews of the medication list, it makes sense to re-examine the efficacy of each medication. Do the benefits of each medication outweigh the risks of negative side effects? Is there room to simplify, or is each medication necessary? It is also important to think about medications whenever a new mood, behavior or physical symptom arises.  Was a new prescription just started, a dose changed or a medication discontinued?
The purpose of this section is to review general principles to keep in mind with regard to medication. It is beyond the scope and purpose of this document to discuss specific medications or treatments. Please be sure to review any specific medication questions with your physician.

Health Care Guidelines

Health care guidelines help define the standards of quality care for individuals with Down syndrome. In addition to specific recommendations for screening tests, they include information about the kinds of medical conditions that individuals with Down syndrome are at risk for and suggestions for early intervention, diet and exercise and other issues across the lifespan.

About Health Care Guidelines

Specialized health care guidelines for individuals with Down syndrome help define potential health care needs for parents so they can better communicate with their primary-care physician.

Prenatal – Age 21

The American Academy of Pediatrics has developed specialized health care information for families of children with Down syndrome that spans the prenatal period through age 21.


Based on the 1999 Down Syndrome Health Care Guidelines for Individuals with Down Syndrome as published in Down Syndrome Quarterly (Volume 4, Number 3, September, 1999, pp. 1-16).

Associated Conditions

People with Down syndrome are at increased risk for certain health problems compared to the general population. This section offers information about these health issues.

ADHD & Down Syndrome

Attention deficit hyperactivity disorder, or ADHD, is a commonly diagnosed childhood problem. However, ADHD-like symptoms are more common in young children with Down syndrome compared to children from the general population.

Alzheimer’s Disease & Down Syndrome

Alzheimer’s disease and Down syndrome share a genetic connection, leading to the increased risk of dementia at an earlier age. Understandably, many families and caregivers are especially worried about this possibility, which is one reason why this topic is covered in detail in this section. Getting accurate information and education about the risk of Alzheimer’s disease is an important way of empowering oneself to prepare for the future.

Anesthesia & Down Syndrome

Complications of anesthesia (sedation during surgery) occur in all patient populations, but are more likely to occur in individuals with Down syndrome than their peers without.

Atlantoaxial Instability & Down Syndrome

Individuals with Down syndrome are at an increased risk of atlantoaxial instability, a serious disorder that could result in spinal cord damage.

Blood Diseases & Down Syndrome

Individuals with Down syndrome frequently show abnormalities in the blood cells for various reasons.

Dental Issues & Down Syndrome

Dental care is important for everybody, but people with Down syndrome can have a number of differences that can require special attention.

Dual Diagnosis of Down Syndrome & Autism

Autism spectrum disorder occurs more frequently in individuals with Down syndrome than in the general population.

Ear, Nose & Throat Issues & Down Syndrome

Ear, nose, and throat problems are common in children with Down syndrome. It is important for primary care physicians and caregivers to be aware of these problems, most of which are present throughout an individual’s life.

Endocrine Conditions & Down Syndrome

Individuals with Down syndrome have a higher incidence of endocrine problems than the general population. The endocrine system refers to a set of glands that include the thyroid, adrenal and pituitary glands.

Gastrointestinal Tract & Down Syndrome

Beginning in the newborn period, people with Down syndrome have an increased likelihood of developing medical conditions that interrupt or interfere with this digestion.

The Heart & Down Syndrome

Abnormalities of the cardiovascular system are common in Down syndrome, as approximately half of all infants born with Down syndrome have a heart defect.

Mental Health Issues & Down Syndrome

At least half of all children and adults with Down syndrome face a major mental health concern during their life span.

Obstructive Sleep Apnea & Down Syndrome

Studies show that half to all people with Down syndrome have obstructive sleep apnea. This can contribute a number of potentially serious health concerns.

Vision & Down Syndrome

Down syndrome has effects on the developing eye, which could impact the proper development of vision.