Mental Health Clinician Volume 2: Issue 11

Select Issue

Children and adolescent psychopharmacology

PharmD, BCPP

The treatment of childhood onset of mental illness can be perplexing. Mental illness does not always wait until adulthood; the National Institute of Mental Health estimates 12 million children and adolescents have a diagnosable mental disorder. The availability of evidence that guides treatment tends to be sparse and few medications are Food and Drug Administration (FDA) approved for the use in those who suffer yet are younger than eighteen. One notable exception, attention-deficit, hyperactivity disorder (ADHD), has garnered enough evidence for solid treatment options. Drs. Linn, Murray, Smith and Fuentes review clinical considerations in the management of ADHD in a

Download PDF

Toolbox: Psychotropic medications approved in children and adolescents

PharmD, BCPP

DOI: 10.9740/mhc.n145473

The following are charts that provide FDA-approved indications in the pediatric population

ATTENTION-DEFICIT HYPERACTIVITY DISORDER MEDICATIONS

ANTIPSYCHOTIC MEDICATIONS & MOOD STABILIZER WITH PSYCHIATRIC INDICATIONS IN CHILDREN/ADOLESCENTS

ANTIDEPRESSANT MEDICATIONS

Download PDF

Psychotropic medication use in foster children: An opportunity for psychiatric pharmacists

PharmD, BCPP, FASHP,

PharmD, BCPP, and

DOI: 10.9740/mhc.n145471

The use of psychotropic medications in United States foster care children is an issue of growing concern among clinicians, child serving agencies, and legislators. Although pharmacologic interventions are accepted as part of multi-modal treatment strategies for many symptoms of mental illness, the relatively high use of psychotropic agents in this population, as well as the limited data on efficacy and both short and long-term adverse effect risks, have led to increased scrutiny. In addition to safety, issues of concern include indications for use, overdiagnosis, appropriate consent for treatment, oversight/monitoring of psychotropic prescribing and psychiatric consultation, and the availability of medication

Download PDF

The use of second generation antipsychotics in children and adolescents with bipolar disorder and schizophrenia: A summary of the AHRQ comparative effectiveness review

PharmD candidate and

Pharm.D., BCPP, FCCP

DOI: 10.9740/mhc.n147199

Second generation antipsychotics (SGAs) can be effective in treating mood disorders in pediatric patients; however, these medications also present with a risk of serious adverse effects. A recent review by the Agency for Healthcare Research and Quality (AHRQ) evaluated the use of SGAs in pediatric patients. This article summarizes the findings of the review, with a focus on bipolar disorder and schizophrenia.

Download PDF

Recognizing and referring at-risk youth

PharmD, BCPP

DOI: 10.9740/mhc.n145475

Nearly 20% of children and adolescents in the US have at least one mental health condition yet less than half of these youth are engaged in treatment. Violent acts such as school shootings, suicide and even bullying have been attributed in part to inadequate mental health awareness, screening and follow-up care in youth. Children and adolescents with persistent behavioral problems, low academic functioning and high rates of psychosocial adversity are ideal candidates for mental health screening in schools and the community. School-based screening offers easier access and less stigma while community care offers the opportunity for more specialized psychiatric evaluation and treatment. There are simple validated screening tools for the most common mental health problems in youth such as anxiety, depression, substance abuse, autistic spectrum disorder, attention-deficit hyperactivity disorder and suicidality. This paper provides an overview of the prevalence of psychiatric disorders in children and adolescents and recommends screening tools to facilitate recognition and referral for additional evaluation and therapeutic intervention.

Download PDF

Clinical considerations for the management of pediatric patients with attention-deficit/hyperactivity disorder

PharmD, BCPS,

PharmD,

PharmD, and

PharmD, BCPP, CGP

DOI: 10.9740/mhc.n145467

Introduction: Attention-deficit/hyperactivity disorder (ADHD) is a chronic health condition presenting with symptoms of hyperactivity, impulsivity, and/or inattention in early childhood, adolescence and adulthood. Many patients will persist with associated symptoms throughout their life and may require long term treatment to maintain adequate control.

Objective: The purpose of this article is to review the current literature in regards to diagnosis, treatment, and management of ADHD in the pediatric and adolescent population.

Methods: A search was conducted using PubMed, Medline, Ovid, and CINHAL with a focus on studies and reviews in the English language from 2008 – 2013, featuring pediatric/adolescent patients across the ages of 4–17 years using the terms: “management”, “attention-deficit”, “hyperactivity”, and “treatment.” Literature referenced prior to the five-year time frame outlined herein provided foundational information on diagnostics and medications.

Discussion: Stimulants, in conjunction with behavioral therapy, are standard first line treatments used in ADHD. While stimulant medications have been shown to be effective in treating symptoms associated with ADHD, there are a variety of concerns that may prevent their use. These concerns are related to adverse consequences, many of which are not supported by concrete evidence. Other pharmacotherapy options such as norepinephrine reuptake inhibitors and selective alpha-2 adrenergic agonists are typically reserved as second line options. The use of novel and emerging complementary therapies will also be explored.

Conclusion: Patients diagnosed with ADHD must be thoroughly evaluated when making decisions regarding treatment. Many studies and reviews support the efficacy of pharmacotherapy in treatment of ADHD; however, there is insufficient evidence regarding long-term safety of the medications. Further research is warranted to evaluate current treatment options and associated risks and benefits to guide the clinician in optimal management of these patients.

Download PDF

Second generation antipsychotics & nocturnal enuresis in children

RPh, BCPP, PharmD Candidate 2015

DOI: 10.9740/mhc.n146896

Nocturnal enuresis, or involuntary wetting during sleep, is an adverse drug reaction that may occur with numerous second generation antipsychotics (SGAs) and currently is underreported. This article reviews SGA-induced enuresis and its management.

Download PDF

Summary of 2012 Cochrane collaboration meta-analysis covering newer generation antidepressants for depressive disorders in children and adolescents

PharmD Candidate and

Pharm.D., BCPP, FCCP

DOI: 10.9740/mhc.n147192

The Cochrane Collaboration recently published a meta-analysis on the use of newer generation antidepressants for the treatment of depressive disorders in children and adolescent patients. This article summarizes their findings.

Download PDF

Treatment options for Tourette syndrome

PharmD and

PharmD candidate

DOI: 10.9740/mhc.n147207

Tics are commonly observed in children, and Tourette Syndrome (TS) represents one end of the spectrum of tic disorders. This article reviews the treatment options for TS.

Download PDF

Book Review: Get the residency: ASHP's guide to residency interviews and preparation

PharmD, BCPP

DOI: 10.9740/mhc.n147515

CPNP members maintain a suggested reading list to provide information on peer recommended resources and convenient access to the highest quality neuropsychopharmacology publications. A reminder that if you shop with CPNP, by following the links below to Amazon, a small commission will be paid to CPNP which helps to financially support our mission to improve the minds and lives of individuals with psychiatric and/or neurologic disorders.

You can help grow this list of resources by suggesting a book.

Book: Get the Residency: ASHP's Guide to Residency Interviews and Preparation

From the publisher

You need to

Download PDF

Movie Review: My left foot

PharmD, BCPP and

DOI: 10.9740/mhc.n147234

STUDENT PERSPECTIVE

“My Left Foot” is a true story based on the life of Irish painter, poet and author Christy Brown. The story is told from his perspective through flashbacks. His perspective is a first person perspective which allows the audience to get an in depth account of what life is like through the eyes of someone with a disability.

Christy Brown was born with cerebral palsy on June 5^th 1932 in Dublin, Ireland to a large poor Irish family. His condition made him crippled and inaudible; his only vocal ability was speaking in rasping sounds.

Download PDF

The annual state of CPNP report

DOI: 10.9740/mhc.n147360

Our 16^th Annual Meeting is now on the record. What a positive experience!! Thanks to the Program Committee (chaired by Jody Malhotra), the Recertification Editorial Board (chaired by Sarah Melton) and the many others (most especially the CPNP Staff – Brenda Schimenti, Greg Payne, and Vanessa Wasser) for the endless hours of effort they put in to make this a successful meeting full of stimulating programming. Once again, The Broadmoor proved to be a wonderful venue for our meeting; several of us realized that the resident deer remembered us from our last meeting!!

I know that there are

Download PDF

CPNP Announcements

DOI: 10.9740/mhc.n145180

CPNP UNIVERSITY PRODUCT ADDRESSING NEGATIVE SYMPTOMS IN SCHIZOPHRENIA AVAILABLE

Schizophrenia is a chronic, debilitating disorder in which successful long-term management represents a considerable clinical challenge. However, recent advances in the field are beginning to show promise toward enabling clinicians to render effective, personalized care. This activity will examine diagnostic tools for effective symptom assessment in schizophrenia and evolving theories on the pathogenesis of schizophrenia. The limitations of current antipsychotics will also be discussed, as well as the emergence of novel therapeutics with unique receptor binding profiles with the potential to improve patient outcomes.

This complimentary, knowledge-based course consists of four

Download PDF

Children and adolescent psychopharmacology

Toolbox: Psychotropic medications approved in children and adolescents

ATTENTION-DEFICIT HYPERACTIVITY DISORDER MEDICATIONS

ANTIPSYCHOTIC MEDICATIONS & MOOD STABILIZER WITH PSYCHIATRIC INDICATIONS IN CHILDREN/ADOLESCENTS

ANTIDEPRESSANT MEDICATIONS

Psychotropic medication use in foster children: An opportunity for psychiatric pharmacists

The use of second generation antipsychotics in children and adolescents with bipolar disorder and schizophrenia: A summary of the AHRQ comparative effectiveness review

Recognizing and referring at-risk youth

Clinical considerations for the management of pediatric patients with attention-deficit/hyperactivity disorder

Second generation antipsychotics & nocturnal enuresis in children

Summary of 2012 Cochrane collaboration meta-analysis covering newer generation antidepressants for depressive disorders in children and adolescents

Treatment options for Tourette syndrome

Book Review: Get the residency: ASHP's guide to residency interviews and preparation

From the publisher

Movie Review: My left foot

STUDENT PERSPECTIVE

The annual state of CPNP report

CPNP Announcements

CPNP UNIVERSITY PRODUCT ADDRESSING NEGATIVE SYMPTOMS IN SCHIZOPHRENIA AVAILABLE

Pharmacist administration of long-acting injectable medications for substance use disorders: A scoping review

Transitions of care: Assessment of adherence to long-acting injectable antipsychotic treatment following discharge from inpatient psychiatry

Use of atypical antipsychotics in individuals with anorexia nervosa

Potential changes impacting psychiatric pharmacy by 2030

A model for timely dissemination of critical information: Clozapine toxicity during the COVID pandemic