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https://www.readbyqxmd.com/read/29517873/-prescriptions-in-child-psychiatry-on-the-use-of-antipsychotic-drugs-for-children-and-adolescents
#1
F Mathy, A Malchair
In line with Evidence-based medicine and more recently with the emergence of Evidence-based practice in psychology, what are the current trends in medical prescriptions in child psychiatry? The use of psychotropic drugs for children and adolescents is constantly increasing, although most pharmacological prescriptions in child psychiatry result in off-label drug use. This article aims at understanding the legal and scientific framework that regulates the prescription of psychopharmacological treatments for children and adolescents...
February 2018: Revue Médicale de Liège
https://www.readbyqxmd.com/read/29449869/off-label-prescription-of-psychiatric-drugs-by-non-psychiatrist-physicians-in-three-general-hospitals-in-germany
#2
Caroline Lücke, Jürgen M Gschossmann, Teja W Grömer, Sebastian Moeller, Charlotte E Schneider, Aikaterini Zikidi, Alexandra Philipsen, Helge H O Müller
Background: Off-label prescribing of psychoactive drugs is a common practice in psychiatry. Here, we sought to investigate the frequency of off-label prescribing in a population of hospitalized patients with a somatic illness who were also suffering from a psychiatric pathology. Methods: Using a prospective, observational design, we collected data from 982 hospitalized patients with a somatic illness for whom a psychiatric consultation was requested because of the presence of additional psychiatric symptoms...
2018: Annals of General Psychiatry
https://www.readbyqxmd.com/read/29381388/long-acting-injectable-atypical-antipsychotic-use-in-adolescents-an-observational-study
#3
Adriana Fortea, Daniel Ilzarbe, Laura Espinosa, Mireia Solerdelcoll, Clara de Castro, Giovanni Oriolo, Gisela Sugranyes, Inmaculada Baeza
OBJECTIVES: Although second generation long-acting injectable antipsychotics (SG-LAIAs) have been approved and are widely used in adults, there is limited evidence for the use of long-acting formulations in children and adolescents. Thus, we systematically describe the off-label use of SG-LAIAs in clinical practice in adolescent inpatients. METHODS: All individuals admitted to our Children and Adolescent Inpatient Psychiatry Unit receiving treatment with SG-LAIAs between January 2013 and June 2016 were reviewed...
January 30, 2018: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/29303800/prescribing-trends-of-atypical-antipsychotic-drugs-in-an-outpatient-unit-of-a-child-and-adolescent-clinic-in-turkey
#4
Çiğdem Yektaş, Ali Evren Tufan
OBJECTIVE: Use of antipsychotic agents in the management of various psychopathologies in Child and Adolescent Psychiatric practice is gradually increasing. This study aimed to evaluate the sociodemographic and clinical features of children and adolescents who applied to an outpatient clinic of child and adolescent psychiatry department in Turkey and were prescribed atypical antipsychotics. METHOD: Patients with prescription codes of ATC N05A (except N05AN lithium) were accepted to denote those with atypical antipsychotic treatment...
January 2018: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/29205757/enhancing-metabolic-monitoring-for-children-and-adolescents-using-second-generation-antipsychotics
#5
Mary Coughlin, Catherine L Goldie, Deborah Tregunno, Joan Tranmer, Marina Kanellos-Sutton, Sarosh Khalid-Khan
The prevalence of children and adolescents using second-generation antipsychotics (SGAs) has increased significantly in recent years. In this population, SGAs are used to treat mood and behavioural disorders although considered 'off-label' or not approved for these indications. Metabolic monitoring is the systematic physical health assessment of antipsychotic users utilized to detect cardiovascular and endocrine side effects and prevent adverse events such as weight gain, hyperglycaemia, hyperlipidemia, and arrhythmias...
December 4, 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/28702268/distressing-visual-hallucinations-after-treatment-with-trazodone
#6
Gustavo Santos, Ana Maria Moreira
Trazodone, a second-generation atypical antidepressant, is increasingly being used off-label, in the treatment of insomnia. Although generally well tolerated, trazodone treatment can be associated with some complications. We describe a case of a 60-year-old man who received trazodone for primary insomnia. He returned, to the emergency department, two days later with distressing visual hallucinations, which prompted inpatient treatment. Trazodone was discontinued, leading to a complete resolution of his visual hallucinations, and he was treated with mirtazapine for 6 months...
2017: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/28540033/use-of-repeated-intravenous-ketamine-therapy-in-treatment-resistant-bipolar-depression-with-suicidal-behaviour-a-case-report-from-spain
#7
REVIEW
Álvaro López-Díaz, José Luis Fernández-González, José Evaristo Luján-Jiménez, Sara Galiano-Rus, Luis Gutiérrez-Rojas
The rapidly-acting antidepressant properties of ketamine are a trend topic in psychiatry. Despite its robust effects, these are ephemeral and can lead to certain adverse events. For this reason, there is still a general concern around the off-label use of ketamine in clinical practice settings. Nonetheless, for refractory depression, it should be an indication to consider. We report the case of a female patient admitted for several months due to a treatment-resistant depressive bipolar episode with chronic suicidal behaviour...
April 2017: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/28430672/lamotrigine-uses-in-psychiatric-practice-beyond-bipolar-prophylaxis-a-hope-or-hype
#8
Ahmed Naguy, Najah Al-Enezi
BACKGROUND: Lamotrigine (LAM), an antiepileptic, with panoply of indications and uses in neurology, is FDA approved, in psychiatry, for bipolar prophylaxis. Apart from this indication, trend of its use in psychiatry is on the rise addressing a multitude of disorders. STUDY QUESTION: LAM remains one of only few psychotropic drugs with antiglutamate activity. This might render LAM a potential therapeutic option in treatment-resistant major psychiatric disorders. We reviewed LAM pharmacology and its diverse indications while examining the extant evidence...
April 19, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28164355/analysis-of-the-appropriateness-of-off-label-antipsychotic-use-for-mental-health-indications-in-a-veteran-population
#9
Jacob T Painter, Richard Owen, Kathy L Henderson, Mark S Bauer, Dinesh Mittal, Teresa J Hudson
STUDY OBJECTIVE: A substantial proportion of antipsychotic (AP) use in veterans is for nonapproved indications (i.e., off-label prescribing). Not all off-label use is necessarily detrimental to patients, however, and in certain situations, off-label prescribing could be considered justifiable. The objective of this study was to determine the extent to which off-label AP prescribing in a veteran population was potentially appropriate. DESIGN: Expert panel and retrospective analysis...
April 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/27737474/pharmacotherapy-in-psychiatric-disorders-of-children-current-evidence-and-trends
#10
M Kölch, P L Plener
Pharmacotherapeutic interventions are available for most psychiatric disorders in children. Evidence for these interventions varies, depending on the targeted disorders. For attention-deficit/hyperactivity disorder, a sound database on efficacy and safety of medication exists. For other common disorders or psychopathological phenomena like disruptive behavior, anxiety disorders, depressive disorders, or autism, data on efficacy and safety are much scarcer. This selective review aims to provide an overview about current psychopharmacological interventions in child and adolescent psychiatry...
November 2016: Pharmacopsychiatry
https://www.readbyqxmd.com/read/27711942/reversible-valproic-acid-induced-parkinsonism-and-cognitive-impairment-in-an-elderly-patient-with-bipolar-disorder-i
#11
Sameer Hassamal, Susan Waller, Kimberly Reese, Claudia Testa
Valproic acid (VPA) is approved by the Food and Drug Administration (FDA) for the treatment of manic or mixed episodes associated with bipolar disorder. VPA is also used off-label to treat other conditions in psychiatry such as impulse control disorders, major depression, and posttraumatic stress disorder (PTSD). Although VPA is mostly well-tolerated, common adverse effects include gastrointestinal symptoms (nausea, vomiting, diarrhea), neurological symptoms (sedation, ataxia, tremor), weight gain, and alopecia...
2016: Türk Psikiyatri Dergisi, Turkish Journal of Psychiatry
https://www.readbyqxmd.com/read/27551945/therapeutic-drug-monitoring-as-a-measure-of-proactive-pharmacovigilance-in-child-and-adolescent-psychiatry
#12
REVIEW
Manfred Gerlach, Karin Egberts, Su-Yin Dang, Paul Plener, Regina Taurines, Claudia Mehler-Wex, Marcel Romanos
Off-label or unlicensed use of psychotropic drugs is common rather than the exception in child and adolescent psychiatry. This use exposes patients to an unknown additional risk of ineffective or even harmful treatment. In addition, treatment with psychotropic drugs during a period of life when the patient undergoes marked developmental hormonal and neurobiological changes often requires different dosing regimes in later life and may result in adverse drug reactions, which are either not seen in adults at all or not in the same frequency...
November 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27529772/off-label-prescription-of-psychopharmacological-drugs-in-child-and-adolescent-psychiatry
#13
Julie Vestergaard Braüner, Lily Manzello Johansen, Troels Roesbjerg, Anne Katrine Pagsberg
This study aimed to describe the frequency of off-label prescriptions of psychopharmacological drugs in a child and adolescent psychiatric setting. A cross-sectional study was conducted on November 1, 2014, including all inpatients and outpatients at the Mental Health Centre for Child and Adolescent Psychiatry, Capital Region of Denmark, aged 0 to 17 years receiving medical treatment with antidepressants, antipsychotic agents, benzodiazepines, melatonin and/or attention deficit hyperactivity disorder (ADHD) medication...
October 2016: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/27098018/bap-position-statement-off-label-prescribing-of-psychotropic-medication-to-children-and-adolescents
#14
EDITORIAL
Aditya N Sharma, Celso Arango, David Coghill, Paul Gringras, David J Nutt, Peter Pratt, Allan H Young, Chris Hollis
The off-label use of medicines for children and adolescents remains a common and important issue for prescribing practice across child and adolescent psychiatry, paediatrics and primary care. This editorial focusses on psychotropic drug treatment, which plays an essential part in the comprehensive management of a range of child and adolescent psychiatric disorders. Despite a growing evidence base for drug treatment in child and adolescent psychiatric disorders, much psychotropic medication continues to be prescribed off-label (i...
May 2016: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/26260136/off-label-prescribing-by-psychiatrists-what-is-the-practitioner-s-liability
#15
Christophe Bartoli, Caroline Berland-Benhaim, Caroline Sastre, Valerie Baillif-Couniou, Pascal Kintz, Georges Leonetti, Anne-Laure Pelissier-Alicot
In psychiatry, the molecules available and the dosages recommended when a drug receives marketing authorization are not always adequate to treat patients with major behavioral disturbances. Off-label prescribing is frequent in this context, with regard to the indications and the dosages given as well as to the drug combinations used. However, if complications or death occur, the practitioner's liability may be engaged. The authors report three deaths attributed to off-label prescribing in psychiatry and which led to charges against the physicians...
November 2015: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/26166453/unmet-needs-in-paediatric-psychopharmacology-present-scenario-and-future-perspectives
#16
REVIEW
Antonio M Persico, Celso Arango, Jan K Buitelaar, Christoph U Correll, Jeffrey C Glennon, Pieter J Hoekstra, Carmen Moreno, Benedetto Vitiello, Jacob Vorstman, Alessandro Zuddas
Paediatric psychopharmacology holds great promise in two equally important areas of enormous biomedical and social impact, namely the treatment of behavioural abnormalities in children and adolescents, and the prevention of psychiatric disorders with adolescent- or adult-onset. Yet, in striking contrast, pharmacological treatment options presently available in child and adolescent psychiatry are dramatically limited. The most important currently unmet needs in paediatric psychopharmacology are: the frequent off-label prescription of medications to children and adolescents based exclusively on data from randomized controlled studies involving adult patients; the frequent lack of age-specific dose, long-term efficacy and tolerability/safety data; the lack of effective medications for many paediatric psychiatric disorders, most critically autism spectrum disorder; the scarcity and limitations of randomized placebo-controlled trials in paediatric psychopharmacology; the unexplored potential for the prevention of psychiatric disorders with adolescent- and adult-onset; the current lack of biomarkers to predict treatment response and severe adverse effects; the need for better preclinical data to foster the successful development of novel drug therapies; and the effective dissemination of evidence-based treatments to the general public, to better inform patients and families of the benefits and risks of pharmacological interventions during development...
October 2015: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/26103533/experiences-with-patient-refusal-of-off-label-prescribing-of-psychotropic-medications-to-children-and-adolescents-in-japan
#17
Noa Tsujii, Takuya Saito, Yuji Izumoto, Masahide Usami, Takashi Okada, Hideki Negoro, Junzo Iida
OBJECTIVE: In child and adolescent psychiatry, the off-label prescribing of psychotropic medications is common. The purpose of this study was to examine the experiences of Japanese child and adolescent psychiatrists with off-label prescribing to children and/or adolescents (hereafter referred to as "children") and to identify the factors associated with these experiences. METHODS: A prospective questionnaire was sent to 1628 psychiatrists belonging to the Japanese Society for Child and Adolescent Psychiatry...
September 2016: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/26012242/reasons-for-and-frequency-of-off-label-drug-use
#18
Svetlana Goločorbin Kon, Ivana Iliković, Momir Mikov
INTRODUCTION: The application of drugs in accordance with the marketing authorization issued by the regulatory authority is considered on-label use, while off-label drug use frequently occurs in medical practice. It includes the application of drugs beyond approved indications; for unapproved age group, with different dosage regimens or different administration route. Medical specialists frequently prescribe an off-label drug in pediatrics, neonatology, geriatrics, psychiatry and oncology...
January 2015: Medicinski Pregled
https://www.readbyqxmd.com/read/25951625/-hyperkinetic-disorders-in-childhood-and-adolescence-an-analysis-of-kinderagate-2009-2012
#19
COMPARATIVE STUDY
Benedikt Stegmann, Christian A Rexroth, Katharina Wenzel-Seifert, Ekkehard Haen
OBJECTIVE: This contribution evaluates the prevalence, medication use as well as age and sex distribution in inpatients with hyperkinetic disorders at the KinderAGATE hospitals for 2009-2012. METHOD: The age, sex, leading diagnosis, prescribed medication, and dosage of each patient were recorded anonymously twice a year. They provide an outstanding epidemiological basis for the observation of the actual situation in child and adolescent psychiatry. RESULTS: Compared to our patient collective, patients diagnosed with hyperkinetic disorders (25...
March 2015: Zeitschrift Für Kinder- und Jugendpsychiatrie und Psychotherapie
https://www.readbyqxmd.com/read/25817088/-use-of-valproic-acid-in-long-stay-units-of-psychiatry
#20
M Teresa Martínez-Lazcano, Sara Esplá-González, Paola Herraiz-Robles, Pilar Hernández-Pérez, Raquel Chillerón-Cuenca, Emilio Pol-Yanguas
OBJECTIVE: Valproic acid is often used in psychiatry to treat schizophrenia and other conditions outside of indication ("off-label"). However, its effectiveness has not been sufficiently demonstrated and its use is not exempt of adverse effects. This study's main objective is to determine the frequency of use of valproic acid in approved indications and the "off-label" use in psychiatric patients. METHODS: A cross-sectional study on July 7, 2014 with a sample of 167 patients residents in a psychiatric center was designed...
March 1, 2015: Farmacia Hospitalaria
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