AD's, AP's and Anxiolytics in Kids Flashcards
Antidepressants in children are used to treat:
Depression
Anxiety
Enuresis
OCD
Of tricyclics the following have been used:
Clomipramine 50-100
Desipramine 25-125
Imipramine 25-150
Especially with desipramine there is a potential for…
Cardiac Electrical Changes
In addition to cardiac electric changes there is also the risk for:
Overdose
Tricyclics have a ________ effect in children.
Sedating
These AD’s have shown increased suicide risk in children & adolescents.
SSRI’s
Of the SSRI’s, these have been effective in treating OCD.
Fluoxetine 5-40
Fluvoxemine 50-150
Sertraline 25-150
Because of their long half-life they permit:
Once a day dosing
The other SSRI’s used in children?
Paroxetine 10-30
Citalopram 5-40
Escitalopram 10-20
SSRI’s often have a paradoxical __________ effect on children
Simulating - Activation characterized by motor restlessness, insomnia
Side effects include: (DCAS)
Diarrhea
Cramps
Anorexia
Sedation
In response to the alleged increased suicide risk, the FDA has assured:
Labelling on product, ensuring doctors & patients are aware of risk
In regard to education, patients & family must know what about tricyclics?
CAN BE FATAL IN OVERDOSE
In regard to SSRI’s?
Can cause motor restlessness, insomnia, irritability
How long until they work?
2-4 weeks, same as in adults.
We also need to teach parents and children about…
Interactions - tricyclics, dextromethorphan DM (SS) increase other drugs, MAOI (SS) anticholinergics, antihistamines
AP’s are used to treat these 5 in children.
Psychosis Severe agression Pervasive Development Disorder Tourettes Tics
Out of the AP’s, the most widely used is:
Risperidone 1-3.5
These 6 AP’s are used in treating children:
Chlorpromazine 25-300 *Agranulocytosis* Haloperiodol 1-6 Fluphenazine 1-2.5 Thiothixene 5-40 Pimozide 2-4 Risperidone 1-3.5
Common side effects?
Anticholinergic, Postural Hypotension, Hypersensitivty, Agranulocytosis, Endocrine, Ocular
The most disturbing side effect which may be permanent?
Tardive Dyskenisa (fly-catcher,trombone, athetoid)
To aide in preventing tardive dyskensia we suggest..
Gradual withdrawal from AP’s
We have to ensure the family/patient..
Aware of the SFX, especially dystonia/dyskenisia
T/F AP’s in children will eradicate tics.
FALSE - improvement at best
Are benzos and barbs used in children?
No - because of risks associated
One anxiolytic that is used in children?
Buspirone - no dependence
In addition, to treat anxiety in children we may use:
SSRI, AP-risperidone
Dose range for buspirone in children?
10-20/day in 2 doses
Side effects of buspirone in children? (3)
Tiredness
Sleep disturbance
Headache
