7/9/2013. Psychiatric medication treatment in children and adolescents: The good, the bad and the ugly. What ADHD is
|
|
- Brook Lucas
- 5 years ago
- Views:
Transcription
1 Psychiatric medication treatment in children and adolescents: The good, the bad and the ugly Gabrielle A. Carlson, MD Professor of Psychiatry and Pediatrics Director, Child and Adolescent Psychiatry Stony Brook University School of Medicine What ADHD is ADHD is a heterogeneous, clinical condition If appropriately defined (with symptoms, pervasiveness and impairment) it may constitute a difference of degree and possibly kind from normal ; symptoms in >2 settings Deficit does not mean None. It means that attention cannot be sustained when the child or adult is not interested. It occurs in children all over the world (i.e. it is not a US invention); rates ~5-8% MOTHER S RATING FOR STEVE TEACHER RATING FOR STEVE 1
2 Lifetime Impairments of ADHD Disruptive behavior Low self-esteem Smoking Substance use Crime Car accidents Relationship failures Poor work history Chronic substance abuse and dependence Incarceration Preschool School-age Adolescent College-age Adult Academic failure Poor socialization Self-esteem issues Injuries Academic failure Occupational failure Substance abuse Slide courtesy of Joseph Biederman, MD. Medication Treatment for ADHD in USA Stimulant Non-Stimulant Short-acting Ritalin Focalin MPH-based Intermediate Dextroamphetamine based Long acting Concerta Ritalin SR Metadate CD Metadate ER Ritalin LA Focalin LA Daytrana Short-acting Approved Strattera Intuniv Kapvay Dextrostat Dexedrine Dexedrine tabs Spansules Adderall Not approved modafanil TCAs Wellbutrin Clonidine Tenex Effexor Intermediate Long-acting Adderall XR Vyvanse Meta-analysis analysis of 29 controlled studies over 25 years, encompassing 4465 children, adolescents) with some added information ( Drug Effect Size Amphetamine 0.92 Methylphenidate 0.80 Atomoxetine 0.73 Guanfacine ER 0.73 Neurofeedback 0.6 Clonidine 0.58* Modafinil 0.49 Bupropion 0.32 Diet without additives 0.2 Faraone SV, Spencer TJ: Presented at: American Psychiatric Association Annual Meeting, Toronto, Canada, May * Connor et al., JAACAP, 1999; Gevensleben et al.,
3 % Normalized at 14-month Endpoint MTA Groups vs. Classroom Controls % % 56% 34% 25% 13.5% Class Cntrls Comb MdMt MedMgt Beh ComCare PATS 0 Endpoint MTA N = 579 Classroom Controls N = 288 Swanson et al. for the MTA Cooperative Group Stimulants and Side effects They MAY cause loss of appetite, delayed sleep, crankiness when the drug wears off For kids on chronic, high doses who don t eat, there may be a slowing of growth that couple be up to about an inch Rates of sudden death probably no higher than unmedicated kids unless there is a family history of sudden and unexplained death. Stimulants do NOT cause problems with the liver, the kidneys, fertility, puberty Cases of psychosis and mania are VERY rare They don t cause or increase rates of drug addiction; the jury is out as to whether they prevent it. DEPRESSION REMEMBER D*U*M*P*S D = DEFINITE PERSONALITY CHANGE - A YOUTH WHO HAS PREVIOUSLY BEEN A GOOD STUDENT OR A NICE KID, SUDDENLY OR EVEN GRADUALLY BECOMES DEFIANT, DISAGREEABLE, DISTANT, DISORGANIZED U = UNDENIABLE DROP IN GRADES - A YOUTH WHOSE GRADES GO FROM As TO Cs OVER A SEMESTER OR WHO STARTS TO AVOID SCHOOL ALTOGETHER OR DEVELOPS "SCHOOL PHOBIA" M = MORBID PREOCCUPATION - A YOUTH WHOSE COMPOSITIONS DWELL ON DEATH AND DISASTER OR WHO VOICES SUICIDAL THOUGHTS OR WHO ENGAGES IN SELF DESTRUCTIVE BEHAVIOR P = PESSIMISM / PSYCHOSIS A YOUTH WHO IS GRIM, DEPRESSED, DEMORALIZED AND SEES NO JOY IN ANYTHING ACUTE ONSET OF DEPRESSIVE HALLUCINATIONS AND/OR DELUSIONS S = SOMATIC COMPLAINTS WITHOUT PHYSICAL BASIS - A YOUTH WHO SPENDS MORE TIME IN THE NURSES OFFICE THAN THE CLASSROOM 3
4 Rise of DSM IV MDD at puberty (Angold et al., 1998) GIRLS BOYS Outcome Episodes last 7-9 months 90% remit by years 40% recur by 2 years Persists from adolescence to adulthood in 60-70% of cases c. 20% develop Bipolar Disorder over the next 5 years associated with acute, severe depression family history of manic-depression or MDD Adverse outcomes: suicide, drug and alcohol problems, social impairment, school drop-out, adult depression Antidepressants - SSRIs Selective serotonin reuptake inhibitors increase serotonin available in synapse Prozac/fluoxetine, Zoloft/sertraline, Celexa/citalopram, Lexapro/escatalopram have the most data in kids They take 2-4 weeks to begin to work Used for depression and anxiety disorders (e.g. OCD, social phobia, separation anxiety disorder, generalized anxiety disorder, panic disorder ) 4
5 Age related Antidepressant response in MDD; Bridge et al., JAMA 297:1683, 2007 Safer, Pediatrics, <.001 <.001 P values AD PBO Adults Teens Children Antidepressants and Suicide in Children In 2004, the FDA looked at 24 clinical trial involving 4,400 children and adolescents taking antidepressants for depression and anxiety disorders. Children taking active meds 4% developed suicidal thoughts/behaviors Children taking placebo 2% No children in studies committed suicide. Putting effectiveness next to side effects: antidepressants help 1/10 depressed children, 1/3 anxious children. Making suicidal threats occurs in 1/112 depressed kids, 1/143 anxious ones Atypical Antipsychotics Risperidone/Risperdal Olanzapine/Zyprexa Quetiapine/Seroquel Ziprasidone/Geodon Aripiprazole/Abilify Clozapine/Clozaril not much in kids GCarlson, MD 5
6 Atypical Antipsychotics Indications/Uses Psychosis (Schizophrenia)-approved for teens Irritability in autism-aripiprazole/abilify and risperidone/risperdal id d approved Mania-risperidone, aripiprazole, quetipine approved for ages 10-17; olanzapine age Also used for Tourettes/Tics Also used for volatile aggression GCarlson, MD Short term risperidone Vs placebo for irritability in behavior disorders and autism se % respons drug placebo drug placebo drug Placebo 10 0 CGI-I >/=2 50% drop Atypical Antipsychotics Adverse Effects Weight gain/obesity Increase blood sugar (diabetes) Increase lipids (cholesterol/triglyceride levels) Sedation Increase prolactin levels amenorrhea, galactorrhea, breast enlargement (males) Cardiovascular - arrhythmias GCarlson, MD 6
7 Weight Gain on Risperidone by Age Percent 12 Increase in 10 Body Weight 8 Over 6 Baseline yrs yrs yrs Age Group yrs Treatment Duration 0wks 4-8 wks 9-16 wks wks Safer DJ, et al., J Clin Psychopharmacol 24: , 2004 Mood Stabilizers Used a fair amount in kids as part of the bipolar epidemic; little in the way of data showing efficacy Lithium sodium valproate/ Depakote Carbamazepine/ Tegretol topirimate/ Topimax Lamotrigine/ Lamictal Oxcarbazepine/Trileptal GCarlson, MD 7
8 UNFORTUNATELY WE DON T HAVE SMART BOMBS We try to use meds systematically But it remains trial and error We need feedback from parents and teachers re: efficacy Meds help some; rarely normality 8
Psychiatric medication treatment in children and adolescents:
Psychiatric medication treatment in children and adolescents: The good, the bad and the ugly Gabrielle A. Carlson, MD Professor of Psychiatry and Pediatrics Director, Child and Adolescent Psychiatry Stony
More informationPsychiatric Medications. Positive and negative effects in the classroom
Psychiatric Medications Positive and negative effects in the classroom Teaching the Medicated Child Beverly Bryant, M.D. Hattiesburg Clinic 9/17/14 Introduction According to the National Survey of Children
More informationJudges Reference Table for the March 2016 Psychotropic Medication Utilization Parameters for Foster Children
Judges Reference Table for the Psychotropic Medication Utilization Parameters for Foster Children Stimulants for treatment of ADHD Preschool (Ages 3-5 years) Child (Ages 6-12 years) Adolescent (Ages 13-17
More informationPediatric Psychopharmacology
Pediatric Psychopharmacology General issues to consider. Pharmacokinetic differences Availability of Clinical Data Psychiatric Disorders can be common in childhood. Early intervention may prevent disorders
More informationAD/HD is a mental disorder, and it often lasts from
short version10 WHAT WE KNOW Managing Medication for Adults with AD/HD AD/HD is a mental disorder, and it often lasts from childhood into adulthood. Medication is the basic part of treatment for adults.
More informationBehavioral Health. Behavioral Health. Prescribing Guidelines
Behavioral Health Behavioral Health Prescribing Guidelines Attention Deficit/Hyperactivity Disorder (ADHD) Start with a first line medication, either from the methylphenidate or dextroamphetamine-amphetamine
More informationPsychopharmacology for Treatment of ADHD and ADHD with other co-existing psychiatric condition
Psychopharmacology for Treatment of ADHD and ADHD with other co-existing psychiatric condition Presented by Cat Dang, D.O Medical Director - Insightful Minds, Inc. Objectives Evaluation process Pharmacology
More informationPL CE LIVE February 2011 Forum
February 2011 PL CE LIVE Kristin W. Weitzel, Pharm.D., CDE, FAPhA Associate Editor and Director of Editorial Projects Pharmacist s Letter/Prescriber s Letter Atypical Antipsychotics Atypical Antipsychotics
More informationAttention Deficit Hyperactivity Disorder (ADHD) in Children under Age 6
in Children under Age 6 Level 0 Conduct comprehensive assessment and provide psychoeducation about ADHD, including clearly defined treatment expectations. Consider co-morbid developmental language disorder,
More informationHumberto Nagera M.D. Director, The Carter-Jenkins Center Psychoanalyst, Children, Adolescents and Adults Professor of Psychiatry at USF Professor
The Carter Jenkins Center presents 1 Humberto Nagera M.D. Director, The Carter-Jenkins Center Psychoanalyst, Children, Adolescents and Adults Professor of Psychiatry at USF Professor Emeritus of Psychiatry
More informationDose Range. Dose Schedule. Child: 5-60 mg Over 50 kg:5-100 mg Focalin, child: mg Over 50 kg: mg. Focalin: 4-5 hrs.
MEDICATIONS FOR ADHD Group Main Use Medication Brand/ Form Dose Schedule Dose Range Most Common Side Effects for Group Pros for Group Cautions for Group methylphenidate Methylin Focalin (dexmethylphenidate)
More informationPerspective Truth on ADHD & Medications. Thomas L. Matthews, M.D. Associate Dean of Student Affairs Professor of Psychiatry
Perspective Truth on ADHD & Medications Thomas L. Matthews, M.D. Associate Dean of Student Affairs Professor of Psychiatry Disclosures National Institute of Health ADHD and Aggression Study Co- Investigator
More informationThings You Might Not Know About Psychotropic Medications But Wish You Did
Things You Might Not Know About Psychotropic Medications But Wish You Did John E. Dunne, MD December 3, 2016 PAL Conference Conflicts of Interest None to report I am employed by Seattle Children s and
More informationEvidence-Based Pharmacotherapy. Emily Harris, MD, MPH, FAAP Cincinnati Children s Hospital Medical Center
Evidence-Based Pharmacotherapy Emily Harris, MD, MPH, FAAP Cincinnati Children s Hospital Medical Center CME Disclosure I have no personal financial relationships in any commercial interest related to
More information2013 Virtual AD/HD Conference 1
Medication for & Coexisting Conditions Part 2 Dr. Kenny Handelman Child, Adolescent & Adult Psychiatrist Halton Healthcare Adjunct Professor of Psychiatry, University of Western Ontario www.drkenny.com
More information475 Child & Adolescent Psychopharmacology p.1
475 Child & Adolescent Psychopharmacology p.1 Introduction? #s of prescriptions for psychoactive meds have increased x2-3 in last 10 years? Ability to diagnose psychiatric disorders in children/adolescents
More informationChild & Adolescent Psychiatry (a brief overview)
Child & Adolescent Psychiatry (a brief overview) Lance Feldman, MD, FAPA, MBA, BSN Vice Chair Clinical Affairs, Department of Psychiatry Affiliate Clinical Assistant Professor, University of South Carolina
More informationSchedule FDA & literature based indications
Psychotropic Medication List Recommended dosages are intended to serve only as a guide for children. Recommended doses are literature based. Clinicians should consult package insert of medications for
More informationBrief Notes on the Mental Health of Children and Adolescents
Brief Notes on the Mental Health of Children and Adolescents The future of our country depends on the mental health and strength of our young people. However, many children have mental health problems
More informationPractical Psychopharmacology for More Complex Mental Health Presentations
MINISTRY OF CHILDREN AND YOUTH SERVICES Practical Psychopharmacology for More Complex Mental Health Presentations Part 1: Stimulants Dr. Ajit Ninan & Joel Lamoure 1 Practical Psychopharmacology for More
More informationAttention Deficit Hyperactivity Disorder State of the Art. Christopher Okiishi, MD
Attention Deficit Hyperactivity Disorder State of the Art Christopher Okiishi, MD What is ADHD? Three subtypes: Inattentive (under diagnosed, esp. in girls) Hyperactive Impulsive Combined Impairments must
More informationGuide to Psychiatric Medications for Children and Adolescents
Guide to Psychiatric Medications for Children and Adolescents by Glenn S. Hirsch, M.D. The following guide includes most of the medications used to treat child and adolescent mental disorders. It lists
More informationBig Lots Behavioral Health. Prescribing Guidelines for Behavioral Health
Big Lots Behavioral Health Prescribing Guidelines for Behavioral Health Prescribing for Behavioral Health This document was developed by Nationwide Children s Hospital in conjunction with Partners For
More informationADHD Medications Table
Stimulants are the first line treatment of choice for ADHD followed by Non-Stimulants, then off-label medications. We are providing this list of medications so that you can be familiar with the common
More informationOhio Psychotropic Medication Quality Improvement Collaborative. Minds Matter. Toolkit. for You and Your Family. This is the property of
Minds Matter Ohio Psychotropic Medication Quality Improvement Collaborative Minds Matter Toolkit for You and Your Family This is the property of About Minds Matter Minds Matter is a project to help teens,
More information4/2/13 COMMON CLASSES OF MEDICATIONS. Child & Adolescent Behavioral Medicine & Medication Therapies. Behavioral Medicine & Medication Therapies
Child & Adolescent Behavioral Medicine & Medication Therapies Brian J Cowles, PharmD Associate Professor of Pharmacy Practice Albany College of Pharmacy & Health Sciences; Vermont Campus Behavioral Medicine
More informationCHILD & ADOLESCENT PSYCHIATRY ALERTS, VOLUME XIV, 2012 INDEX
A Adderall Counterfeit, 31 addiction, internet CBT, 55 ADHD Adjunctive Guanfacine, 11 Counterfeit Adderall, 31 Developmental Trajectory and Risk Factors, 5 Dopamine Transporter Alterations, 14 Extended-Release
More informationA Brief Overview of Psychiatric Pharmacotherapy. Joel V. Oberstar, M.D. Chief Executive Officer
A Brief Overview of Psychiatric Pharmacotherapy Joel V. Oberstar, M.D. Chief Executive Officer Disclosures Some medications discussed are not approved by the FDA for use in the population discussed/described.
More informationMedications and Children Disorders
Mental Health Comprehensive Services Providing Family Stability and Developing Life Coping Skills Medications and Children Disorders Psychiatric medications can be an effective part of the treatment for
More informationWe ll Be Discussing. Pregnancy 4/24/2013
Joe Wegmann, PD, LCSW The PharmaTherapist Joe@ThePharmaTherapist.com 504.587.9798 www.pharmatherapist.com Are you receiving our free monthly e-newsletter? We ll Be Discussing The safety and efficacy track
More informationMedications for Anxiety & Behavior in Williams Syndrome. Disclosure of Potential Conflicts. None 9/22/2016. Evaluation
Medications for Anxiety & Behavior in Williams Syndrome Christopher J. McDougle, M.D. Director, Lurie Center for Autism Professor of Psychiatry and Pediatrics Massachusetts General Hospital and MassGeneral
More informationDrug Class Review. Pharmacologic Treatments for Attention Deficit Hyperactivity Disorder
Drug Class Review Pharmacologic Treatments for Attention Deficit Hyperactivity Disorder Final Update 5 Report July 2015 The purpose of reports is to make available information regarding the comparative
More informationTreating Disruptive Behavior Disorders in Children and Teens. A Review of the Research for Parents and Caregivers
Treating Disruptive Behavior Disorders in Children and Teens A Review of the Research for Parents and Caregivers e Is This Information Right for Me? This information is for you if: A health care professional*
More informationParents Guide to ADHD Medications. Copyright Child Mind Institute
Copyright 2017. Child Mind Institute Children with attention-deficit hyperactivity disorder (ADHD) find it unusually difficult to concentrate on tasks, to pay attention, to sit still and to control impulsive
More informationADHD Medications: Basics. David Benhayon MD, PhD
ADHD Medications: Basics David Benhayon MD, PhD Goals & Objectives Understand basic classes of stimulants and equivalents Be exposed to role of nonstimulant alternatives Discuss the role of therapy in
More informationReview of Psychotrophic Medications. (An approved North Carolina Division of Health Services Regulation Continuing Education Course)
Review of Psychotrophic Medications (An approved North Carolina Division of Health Services Regulation Continuing Education Course) Common Psychiatric Disorders *Schizophrenia *Depression *Bipolar Disorder
More informationThe Use of ADHD Medication in the Pediatric Population
The Use of ADHD Medication in the Pediatric Population Shirin Madzhidova, PharmD Pediatric Pharmacotherapy Fellow Nova Southeastern University Objectives Discuss the importance of treatment with medications
More informationADHD Assessment and Treatment in Primary Care
ADHD Assessment and Treatment in Primary Care Matthew Tolliver, Ph.D., Assistant Professor, ETSU Pediatrics Dr. David Wood, Professor and Chair, ETSU Pediatrics ADHD in Teenagers We have no financial disclosures.
More informationMedically Accepted Indications for Pediatric Use of Psychotropic Medications by
Key: White Background: Medically Accepted Indication Yellow Backgroun: Medically Accepted Indication Status Not Ascertained Orange Background: Pediatric Indication cited, but not supported Red Background:
More informationBig Lots Behavioral Health. Prescribing Guidelines for Behavioral Health
Big Lots Behavioral Health Prescribing Guidelines for Behavioral Health Prescribing for Behavioral Health This document was developed by Nationwide Children s Hospital in conjunction with Partners For
More informationMental Illness. Doreen L. Rasp, APN, FNP, PMHNP Advanced Behavioral Counseling
Mental Illness Doreen L. Rasp, APN, FNP, PMHNP Advanced Behavioral Counseling Moodiness Changing Bodies Narcissism Self-Esteem Ignorant Naïve Insecure Self-Centered Independent Adolescence Disorders Affecting
More informationMedications in Autism: What We Know and Don't Know
Medications in Autism: What We Know and Don't Know Jeremy Veenstra-VanderWeele, M.D. Mortimer D. Sackler, M.D., Associate Professor Center for Autism and the Developing Brain Sackler Institute for Developmental
More informationPharmacologic Management of ADHD
Pharmacologic Management of ADHD CHADD Presentation April 13, 2015 Peter J Chung, MD, FAAP Developmental-Behavioral Pediatrician* Assistant Clinical Professor of Pediatrics University of California Irvine
More informationWhat are the most common signs of ADHD? And what are the most common medication interventions?
What are the most common signs of ADHD? And what are the most common medication interventions? Bennett Gertz, MD, FAAP Developmental Behavioral Pediatrician Children s Developmental Health Services Albertina
More informationADHD: A Focus On Drug Therapy
ADHD: A Focus On Drug Therapy MARY WORTHINGTON, PHARM.D., BCPS MCWHORTER SCHOOL OF PHARMACY BIRMINGHAM, ALABAMA SEPTEMBER 13, 2013 Outpatient Prescription Drug Utilization in US Children, 2002-2010 90
More informationManaging the Behavior Problems of Children With Fragile X Syndrome by Using Medication Ave M. Lachiewicz, MD, Duke University Medical Center
Managing the Behavior Problems of Children With Fragile X Syndrome by Using Medication Ave M. Lachiewicz, MD, Duke University Medical Center Abstract: The majority of boys and many girls with fragile X
More informationADHD Part II: Managing Comorbities
ADHD Part II: Managing Comorbities Brett Johnson, MD Staff Psychiatrist Rady Children s Behavioral Crisis Center Assistant Clinical Professor (Voluntary), UCSD January 26, 2011 Financial Disclosure I have
More informationCreating Partnerships. Laine Young-Walker, MD
Creating Partnerships Laine Young-Walker, MD Psychiatry is the medical specialty devoted to the study, diagnosis, treatment and prevention of mental disorders. Medical school >>>four years of residency
More informationADHD and. Shaw Wendi Fortuchang, M.D. Board certified in Child & Adolescent, Adult, and Forensic Psychiatry
ADHD and Beyond Shaw Wendi Fortuchang, M.D. Board certified in Child & Adolescent, Adult, and Forensic Psychiatry Overview Use of medications in children How do medications work in the brain? Risperdal?
More informationThe Benefits and Limitations of Medication Treatment for Executive Dysfunctions and ADHD
The Benefits and Limitations of Medication Treatment for Executive Dysfunctions and ADHD Damon Korb, MD Behavioral and Developmental Pediatrician Director of the Center for Developing Minds Los Gatos,
More informationADHD Explanation 5: Medications used in ADHD
ADHD Explanation 5: Medications The aim of treatment is efficient functioning and achieving goals in life It is most important to find the dose of medications that works best As children grow they may
More informationUniversity of Texas Health Science Center at San Antonio. Pediatrics Grand Rounds 5 February History of stimulant treatment
Pharmacological Treatment of Attention Deficit Hyperactivity Disorder and its comorbidities Steven R. Pliszka, M.D. Professor and Vice Chair Chief, Division of Child and Adolescent Psychiatry Department
More informationChange Your Brain, Change Your Life. The Breakthrough Program for Conquering Anxiety, Depression, Obsessiveness, Anger, and Impulsiveness
Change Your Brain, Change Your Life The Breakthrough Program for Conquering Anxiety, Depression, Obsessiveness, Anger, and Impulsiveness Daniel G Amen Three Rivers Press New York Appendix Medication 1.
More informationStimulants. The psychostimulants, or more simply known as stimulants, are used primarily in treating attention-deficit/ Dosing Information
Adderall and Adderall-XR (amphetamine mixtures) Concerta (methylphenidate, controlled Dexedrine, Dexedrine Spansules (dextroamphetamine) Focalin (dexmethylphenidate) Metadate, Metadate-ER, and Metadate-CD
More informationIndex. Note: Page numbers of article titles are in boldface type. A ADHD. See Attention-deficit/hyperactivity disorder (ADHD) b-adrenergic blockers
Note: Page numbers of article titles are in boldface type. A ADHD. See Attention-deficit/hyperactivity disorder (ADHD) a-adrenergic blockers for PTSD, 798 b-adrenergic blockers for PTSD, 798 Adrenergic
More informationADHD: Management Update
4/5/17 Conflicts of Interest ADHD: Management Update I have no conflicts to disclose. Jennifer R. Walton, MD, MPH, FAAP April 7, 2017 ADHD: DSM-5 Definition Objectives To briefly review ADHD diagnostic
More informationCriteria for Child Psychiatrist on the Use of Selected Psychotropic Medications in Children & Adolescents
Criteria for Child Psychiatrist on the Use of Selected Psychotropic Medications in Children & Adolescents DRUG NAME INDICATIONS / ACCEPTABLE USES PRIOR STIMULANT/ADHD DRUGS Daytrana (methylphenidate) ADHD
More informationTreat mood, cognition, and behavioral disturbances associated with psychological disorders. Most are not used recreationally or abused
Psychiatric Drugs Psychiatric Drugs Treat mood, cognition, and behavioral disturbances associated with psychological disorders Psychotropic in nature Most are not used recreationally or abused Benzodiazepines
More informationPSYCHIATRIC DRUGS. Mr. D.Raju, M.pharm, Lecturer
PSYCHIATRIC DRUGS Mr. D.Raju, M.pharm, Lecturer PSYCHIATRIC DRUGS Treat mood, cognition, and behavioral disturbances associated with psychological disorders Psychotropic in nature Most are not used recreationally
More informationCHILD & ADOLESCENT PSYCHIATRY ALERTS, VOLUME XV, 2013 INDEX
A acceptance and commitment therapy Posttraumatic Stress, 69 ADHD Adjunctive Fatty Acids, 5 Adjunctive Guanfacine Pharmacokinetics, 27 Amantadine, 21 Atomoxetine, 23 Cancer Risk, 31 CBT for Comorbid Anxiety,
More informationPHARMACY COVERAGE GUIDELINES ORIGINAL EFFECTIVE DATE: 3/15/18 SECTION: DRUGS LAST REVIEW DATE: 3/15/18 LAST CRITERIA REVISION DATE: ARCHIVE DATE:
DYANAVEL XR (amphetamine) extended-release oral suspension Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit
More informationGA KS KY LA MD NJ NV NY TN TX WA Applicable X N/A N/A X N/A X X X X X X N/A N/A X *FHK- Florida Healthy Kids. ADHD Narcolepsy
Override(s) Prior Authorization ADHD Narcolepsy Approval Duration 1 year *Louisiana, Washington and Maryland Medicaid See State Specific Information Below Medications Atomoxetine: Strattera generic Clonidine
More informationFacts about ADHD drugs as treatment
Facts about ADHD drugs as treatment Common ADHD drugs as treatment Medication Stimulants Methylphenidate Dexmethylphenidate Amphetamine Non-Stimulants Straterra Guanfacine ER (Intuniv) Clonidine (Kapvay)
More informationAutism: Improving Health Care Outcomes
AUTISM AWARESS CONFERENCE Lewis County Autism Coalition 23 September 2011 Autism: Improving Health Care Outcomes Glenn C. Tripp, M.D. Developmental Behavioral Pediatrics Medical Director, Developmental
More informationThe Mental Health and Wellbeing of Children and Adolescents who are affected by Autism and Related Disorders
The Mental Health and Wellbeing of Children and Adolescents who are affected by Autism and Related Disorders Charles Cartwright, M.D Director: YAI Autism Center March 2013 Autism Spectrum Defined by the
More informationOhio Psychotropic Medication Quality Improvement Collaborative. Minds Matter. Toolkit. for Youth and Caregivers. This is the property of
Minds Matter Ohio Psychotropic Medication Quality Improvement Collaborative Minds Matter Toolkit for Youth and Caregivers This is the property of About Minds Matter Minds Matter is a statewide project
More informationPresented by the National Resource Center on ADHD
Presented by the National Resource Center on ADHD Timothy E. Wilens, M.D. Massachusetts General Hospital Harvard Medical School Save 25% if you join/rejoin CHADD Use Promo Code: JANA14 If you are currently
More information6/22/2012. Co-morbidity - when two or more conditions occur together. The two conditions may or may not be causally related.
Autism Spectrum Disorders and Co-existing Mental Health Issues By Dr. Karen Berkman Objective To present an overview of common psychiatric conditions that occur in persons with autism spectrum disorders
More informationBipolar Disorder in Youth
Bipolar Disorder in Youth Janet Wozniak, M.D. Associate Professor of Psychiatry Director, Pediatric Bipolar Disorder Research Program Harvard Medical School Massachusetts General Hospital Pediatric-Onset
More informationIntroductory discussion
Billina R. Shaw, MD Assistant Professor University of Maryland School of Medicine Department of Psychiatry Division of Child and Adolescent Psychiatry Introductory discussion Prescribing trends in foster
More informationAsk The Shrink: ADHD
Ask The Shrink: ADHD Theodore A. Petti, MD Professor of Psychiatry Division of Child and Adolescent Psychiatry Robert Wood Johnson Medical School PPC Hub Psychiatrist Hackensack Meridian Hubs @ Saint Peter'
More informationChild and Adolescent Psychopharmacology Made Simple (2nd edition)
Child and Adolescent Psychopharmacology Made Simple (2nd edition) Questions from chapter 1 1) It is likely that the majority of emotional suffering experienced by youngsters is related to a) genetics b)
More information11/11/2018. The ABCs of Medication Management for Autism Spectrum Disorder. ABC Logging (FBA) First. ABC Logging HOW TO COMPLEMENT BEHAVIORAL THERAPY
The ABCs of Medication Management for Autism Spectrum Disorder OR HOW TO COMPLEMENT BEHAVIORAL THERAPY ABC Logging (FBA) First We need to know what, when, where and why behaviors happen. Antecedent: What
More informationWhere to from Here? Evidence-Based Strategies for Treatment of Refractory Depression
Where to from Here? Evidence-Based Strategies for Treatment of Refractory Depression Michael D. Jibson, MD, PhD Professor of Psychiatry University of Michigan Major Depression #1 WHO cause of disability
More informationChapter Sixteen. Psychological Disorders
Chapter Sixteen Psychological Disorders Prevalence of Psychological Disorders? Approximately 25% of the Adult Population here in the U.S. of A. Higher percentages in areas / countries with high poverty
More informationChildhood Rage: Diagnosis and Treatment Strategies for Severe Mood Dysregulation - Part 2: Diagnosis and Treatment
Liberty University DigitalCommons@Liberty University Faculty Publications and Presentations Department for Counselor Education and Family Studies 2013 Childhood Rage: Diagnosis and Treatment Strategies
More informationADHD Stimulant Step Therapy Program
ADHD Stimulant Step Therapy Program Policy Number: 5.01.592 Last Review: 7/2018 Origination: 7/2017 Next Review: 7/2019 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will provide coverage
More informationPharmacotherapy of ADHD Across the Lifecycle: Stimulants
Pharmacotherapy of ADHD Across the Lifecycle: Stimulants Thomas J. Spencer, MD Massachusetts General Hospital Harvard Medical School Percent Change (Bmax/Kd) DVR Images Obtained with [ 11 C]Raclopride
More information3/19/2018. Cynthia King, MD Associate Professor of Psychiatry UNMSOM. Autism Spectrum Disorder
Cynthia King, MD Associate Professor of Psychiatry UNMSOM Autism Spectrum Disorder 1 Identify three behavioral health concerns in ASD Identify three common families of medication that may be supportive
More information3/19/2018. Cynthia King, MD Associate Professor of Psychiatry UNMSOM
Cynthia King, MD Associate Professor of Psychiatry UNMSOM 1 2 Autism Spectrum Disorder 3 Identify three behavioral health concerns in ASD Identify three common families of medication that may be supportive
More informationDrug Class Review Pharmacologic Treatments for Attention Deficit Hyperactivity Disorder
Drug Class Review Pharmacologic Treatments for Attention Deficit Hyperactivity Disorder Final Report Update 3 September 2009 Update 2: November 2007 Update 1: May 2006 Original Report: September 2005 The
More informationAttention Deficit Hyperactivity Disorder (ADHD) BY MARK FABER M.D.
Attention Deficit Hyperactivity Disorder (ADHD) BY MARK FABER M.D. PREVALENCE & STATISTICS 6-8% of all children have ADHD (CDC Statistical Data) Age of onset: 7 years old (Prior DSM-IV) 12 years old (Current
More informationDrugs, Society and Behavior
SOCI 270 Drugs, Society and Behavior Spring 2016 Professor Kurt Reymers, Ph.D. Chapter 8 Medication for Mental Disorders 1. Mental Disorders: a. The Medical Model Model: symptoms diagnosis determination
More informationAggression (Severe) in Children under Age 6
Aggression (Severe) in Children under Age 6 Level 0 Comprehensive diagnostic assessments. Refer to Principles of Practice on page 6. Evaluate and treat comorbid conditions (i.e. medical, other psychiatric
More informationPSYCHIATRY INTAKE FORM
Please complete all information on this form. PSYCHIATRY INTAKE FORM Name Date Date of Birth Primary Care Physician Current Therapist/Counselor What are the problem(s) for which you are seeking help? 1.
More informationMood Disorders for Care Coordinators
Mood Disorders for Care Coordinators David A Harrison, MD, PhD Assistant Professor, Dept of Psychiatry & Behavioral Sciences University of Washington School of Medicine Introduction 1 of 3 Mood disorders
More information5 COMMON QUESTIONS WHEN TREATING DEPRESSION
5 COMMON QUESTIONS WHEN TREATING DEPRESSION Do Antidepressants Increase the Possibility of Suicide? Will I Accidentally Induce Mania if I Prescribe an SSRI? Are Depression Medications Safe and Effective
More informationPresented by the. National Resource Center on ADHD
Presented by the National Resource Center on ADHD www.help4adhd.org (800) 233-4050 Daniel Cox, PhD Director of the Virginia Driving Safety Laboratory Professor of Psychiatric & Internal Medicine, University
More informationPsychotropic Medications in Children and Adolescents: Guide for Use and Monitoring
Psychotropic Medications in Children and Adolescents: Guide for Use and This document was developed by Community Care of North Carolina with the assistance of the Medication Management Workgroup of the
More information5/2/2017. By Pamela Pepper PMH, CNS, BC. DSM-5 Growth and Development
By Pamela Pepper PMH, CNS, BC DSM-5 Growth and Development The idea that diagnosis is based on subjective criteria and that those criteria should fall neatly into a set of categories is not sustainable,
More informationIndividuals with attention-deficit/hyperactivity
National Resource Center on AD HD A program of CHADD 3 WHAT WE KNOW Managing Medication for Children and Adolescents with AD/HD * Individuals with attention-deficit/hyperactivity disorder (AD/HD) experience
More informationASD (hyperactivity) 3 rd LINE TREATMENT Initial liquid dose mg 2. - ADHD symptoms without sleep
Generic Name Label Name Dosing by Disorder RITALIN, RITALIN LA, CONCERTA, METADATE ER, 2 ND LINE TREATMENT 2 ND LINE TREATMENT METADATE CD, MPH ER, Initial liquid dose 1-5 mg 1,2 Initial liquid dose 1-5mg
More informationPsychopharmacology: An Overview
Psychopharmacology: An Overview John Tanquary, M.D. Clinical Assistant Professor Department of Psychiatry Upstate Medical University Psychpharmacology Consultant Le Moyne College Syracuse University Financial
More informationANXIETY: FAST FACTS AND SKILLS FOR THE PRIMARY CARE PHYSICIAN
UW PACC Psychiatry and Addictions Case Conference UW Medicine Psychiatry and Behavioral Sciences ANXIETY: FAST FACTS AND SKILLS FOR THE PRIMARY CARE PHYSICIAN RYAN KIMMEL, MD MEDICAL DIRECTOR HOSPITAL
More informationADHD Medications & How They Work. Gail C. Rodin, Ph.D. January 21, 2008
ADHD Medications & How They Work Gail C. Rodin, Ph.D. January 21, 2008 Agenda How the (ADHD) Brain Works (or doesn t) Neurons and neurotransmitters NE & DA: the major players in ADHD Channel vs. state
More informationIndividuals with attention-deficit/hyperactivity
3 W H A T W E K N O W Managing Medication for Children and Adolescents with AD/HD * Individuals with attention-deficit/hyperactivity disorder (AD/HD) experience chronic problems with inattention and/or
More informationIndividuals with attention-deficit/hyperactivity
National Resource Center on AD HD A program of CHADD 3 WHAT WE KNOW Managing Medication for Children and Adolescents with AD/HD * Individuals with attention-deficit/hyperactivity disorder (AD/HD) experience
More information35 mg NF -- Dextroamphetamine Sulfate IR Tablets: Zenzedi IR Ttablets: Dextroamphetamine Sulfate ER Capsules: 15 mg ProCentra Solution.
MEDICATION COVERAGE POLICY PHARMACY AND THERAPEUTICS ADVISORY COMMITTEE POLICY: ADHD Medications P&T DATE 12/13/2017 CLASS: Psychiatric Disorders REVIEW HISTORY 12/16, 9/15, 5/12, 5/10, LOB: MCL (MONTH/YEAR)
More information