Concepts
80% of Rx
Not approved by the FDA for use in children
Inhibits re-uptake of DA & NE
Methylphenidate (Ritalin, Concerta)
1- Anti-psychotics, 2- Mood stabilizers, 3- Antidepressants
Meds for aggressive sx CD, ODD & DMDD
CBT and SSRIs
Tmt for severe anxiety d/o
Tricyclics
Little to no benefit for pediatrics
Pharmacotherapy + Psychotherapy =
= better results than pharmacotherapy alone.
Blocks re-uptake NE, DA & SE. Blocks VMAT2, l/t Increases DA & NE available
Stimulants MOA
Methylphenidate (Focalin, Ritalin, Concerta)
ADHD Rx
Diphenhydramine (Benadryl)
Short term for sleep disturbances.
Fluoxetine (Prozac), Citalopram (Celexa), and Sertraline (Zoloft)
1st line tmts
Equal to or greater than in adults
Psychotropic dosing in kids (or dosed more frequently)
Blocks reuptake of NE l/t increased NE (& possibly increased DA).
Atomoxetine (Strattera)
Atomoxetine (Strattera) & Guanfacine (Intuniv & Tenex)
Nonstimulants
Separation AD, Generalized AD, Social AD, & Selective Mutism.
Common AD in youth
Escitalopram (Lexapro)
12 and older
TD risk in kids
Greater r/f TD in kids
Alpha 2A agonist: blocks re-uptake of NE
Guanfacine (Intuniv, Tenex)
1- Aripiprazole (Abilify), 2- Risperidone (Risperdal)
ASD: Rx for aggression
Fluvoxamine (Luvox), Fluoxetine (Prozac), Sertraline (Zoloft), & Paroxetine (Paxil)
Antidepressants w/evidence for treating AD in youth.
Escitalopram (Lexapro) & Fluoxetine (Prozac)
Approved by FDA for adolescent depression.
1- Increased liver mass, 2- More renal clearance, 3- Increased levels of drug-metabolizing enzymes
Reasons children clear drugs more rapidly:
Irritability, Aggression & Rapid speech
Top 3 sx of mania in pediatrics
Fluoxetine (Prozac)
Bulimia: Rx
TCAs
NOT recommended d/t side effects
Biological, Psychological & Environmental
Factors for causing depression