By Hendren, Robert L.; Reeve, Alya
This quantity of articles makes a speciality of the more and more vital but debatable subject of psychopharmacologic therapy for adolescent emotional and behavioral issues. It starts off with a pragmatic "when and the way to medicate" guide for basic care physicians after which follows with concise, entire studies of medicines used to regard the main issues obvious in a toddler and family members perform together with substance abuse and complimentary and substitute treatments. Read more...
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Extra info for Adolescent medicine : state of the art reviews : current psychopharmacology for psychiatric disorders in adolescents
Escitalopram in the treatment of adolescent depression: a randomized placebo-controlled multisite trial. J Am Acad Child Adolesc Psychiatry. 2009;48;721–729 36. Hammad TA, Laughren T, Raccoosin J. Suicidality in pediatric patients treated with antidepressant drugs. Arch Gen Psychiatry. 2006;63:332–339 37. Julious SA. Efficacy and suicidal risk for antidepressants in paediatric and adolescent patients. Stat Methods Med Res. 2013;22:190–218 38. Medication Guide. Wayne, PA: Shire US; 2013. PDF. Accessed June 19, 2013.
Accessed July 16, 2013. A. Riddle, et al. A. Riddle, et al. 36 Thus, the risk difference was 2%. 37 The most recent, and presumably best, analyses suggest that there may be a very slight increased risk of suicidality with antidepressants in children and adolescents. Clinical prudence indicates the need to educate patients and parents about suicidality and to provide careful monitoring for suicidality and other adverse effects during the initial phase of treatment (when the risk of suicidality is generally greatest from both the depression and the medication) and throughout treatment.
Conditions for safe and effective prescribing of psychiatric medications by primary care physicians The disorder for which medication is prescribed needs to be: • Sufficiently common to be seen regularly by a PCP • Efficiently and accurately diagnosable by a PCP The medication needs to: • Have demonstrated efficacy • Be relatively safe, as assessed by several parameters • Have side effects that are reasonably predictable, readily detected, and readily managed The dosing and monitoring of the medication need to: • Follow guidelines that are reasonably established and easily followed • Include somatic monitoring that is limited to vital signs and height/weight The prescribing physician needs to have: • Expertise in diagnosing the relevant disorders • Knowledge of available psychosocial treatments (eg, PBMT, CBT) • Knowledge of the medications prescribed • Procedures for monitoring medication effects and adherence The system of care needs to provide: • Access to pediatric psychopharmacology expertise for consultation on issues beyond the expertise of the PCP • Adequate payment for services rendered • Minimal administrative and regulatory barriers CBT, cognitive-behavioral therapy; PBMT, parent behavior management training; PCP, primary care physician.
Adolescent medicine : state of the art reviews : current psychopharmacology for psychiatric disorders in adolescents by Hendren, Robert L.; Reeve, Alya