AD's, AP's and Anxiolytics in Kids

Question 1

Antidepressants in children are used to treat:

Answer 1

Depression
Anxiety
Enuresis
OCD

Question 2

Of tricyclics the following have been used:

Answer 2

Clomipramine 50-100
Desipramine 25-125
Imipramine 25-150

Question 3

Especially with desipramine there is a potential for…

Answer 3

Cardiac Electrical Changes

Question 4

In addition to cardiac electric changes there is also the risk for:

Answer 4

Overdose

Question 5

Tricyclics have a ________ effect in children.

Answer 5

Sedating

Question 6

These AD’s have shown increased suicide risk in children & adolescents.

Answer 6

SSRI’s

Question 7

Of the SSRI’s, these have been effective in treating OCD.

Answer 7

Fluoxetine 5-40
Fluvoxemine 50-150
Sertraline 25-150

Question 8

Because of their long half-life they permit:

Answer 8

Once a day dosing

Question 9

The other SSRI’s used in children?

Answer 9

Paroxetine 10-30
Citalopram 5-40
Escitalopram 10-20

Question 10

SSRI’s often have a paradoxical __________ effect on children

Answer 10

Simulating - Activation characterized by motor restlessness, insomnia

Question 11

Side effects include: (DCAS)

Answer 11

Diarrhea
Cramps
Anorexia
Sedation

Question 12

In response to the alleged increased suicide risk, the FDA has assured:

Answer 12

Labelling on product, ensuring doctors & patients are aware of risk

Question 13

In regard to education, patients & family must know what about tricyclics?

Answer 13

CAN BE FATAL IN OVERDOSE

Question 14

In regard to SSRI’s?

Answer 14

Can cause motor restlessness, insomnia, irritability

Question 15

How long until they work?

Answer 15

2-4 weeks, same as in adults.

Question 16

We also need to teach parents and children about…

Answer 16

Interactions - tricyclics, dextromethorphan DM (SS) increase other drugs, MAOI (SS) anticholinergics, antihistamines

Question 17

AP’s are used to treat these 5 in children.

Answer 17

Psychosis
Severe agression
Pervasive Development Disorder
Tourettes
Tics

Question 18

Out of the AP’s, the most widely used is:

Answer 18

Risperidone 1-3.5

Question 19

These 6 AP’s are used in treating children:

Answer 19

Chlorpromazine 25-300 *Agranulocytosis*
Haloperiodol 1-6
Fluphenazine 1-2.5
Thiothixene 5-40
Pimozide 2-4
Risperidone 1-3.5

Question 20

Common side effects?

Answer 20

Anticholinergic, Postural Hypotension, Hypersensitivty, Agranulocytosis, Endocrine, Ocular

Question 21

The most disturbing side effect which may be permanent?

Answer 21

Tardive Dyskenisa (fly-catcher,trombone, athetoid)

Question 22

To aide in preventing tardive dyskensia we suggest..

Answer 22

Gradual withdrawal from AP’s

Question 23

We have to ensure the family/patient..

Answer 23

Aware of the SFX, especially dystonia/dyskenisia

Question 24

T/F AP’s in children will eradicate tics.

Answer 24

FALSE - improvement at best

Question 25

Are benzos and barbs used in children?

Answer 25

No - because of risks associated

Question 26

One anxiolytic that is used in children?

Answer 26

Buspirone - no dependence

Question 27

In addition, to treat anxiety in children we may use:

Answer 27

SSRI, AP-risperidone

Question 28

Dose range for buspirone in children?

Answer 28

10-20/day in 2 doses

Question 29

Side effects of buspirone in children? (3)

Answer 29

Tiredness
Sleep disturbance
Headache