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Feature Article

Prescribing psychotropic medication in children and adolescents

Philip Hazell

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Abstract

Psychotropic medications are a useful tool to decrease distress and improve functioning in children and adolescents who have psychiatric disorders. Such medications are safe and effective provided clinicians follow good prescribing practice.

Key Points

  • There are nonpharmacological options for most children and adolescents with psychiatric disorders or problems.
  • Pharmacological treatment of uncomplicated obsessive compulsive disorder, anxiety and tic disorders can be undertaken by GPs who fully understand the treatment options and side effects; however, other more complex or controversial disorders are better managed by specialist services.
  • When treating a child or adolescent for a psychiatric disorder, the doses recommended in this article should be followed; however, in patients who have a poor treatment response, doses in the upper range may be necessary.
  • An adequate trial of the drug, in adjusting and scheduling of doses, should be given before considering a change in treatment.
  • Growth parameters should be routinely monitored when following up patients who have been prescribed psychotropic medication.
  • If treatment response is inadequate, adherence to therapy should be monitored before increasing the medication dose. If multiple medications seem necessary, a specialist review should be sought.
  • In patients who are stopping therapy, it can be necessary, particularly with some medication, to taper the doses to avoid the development of a discontinuation syndrome.

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