Internalizing Disorders

Question 1

why do children generally need higher doses of psych meds?

Answer 1

• -faster metabolism
• -kidney clearance
• -increased liver size in relationship to body surface area

Question 2

which dx do you treat 1st?

Answer 2

the primary dx or one that is causing the most functional impairment

Question 3

Level 1 Meds:

Answer 3

• -stimulants
• -SNRIs
• -antidepressants (SSRIs)
• -alpha adrenergic agonists

Question 4

stimulants

Answer 4

• -methylphenidate (Ritalin, Concerta, etc)

- -amphetamine (Dexedrine, Adderall, etc)

Question 5

alpha-2a adrenergic agonists

Answer 5

• -guanfacine (Tenex, Intuniv = guanfacine ER, 6-17 yrs)

- -clonidine (Catapres, Kapvay)

Question 6

SNRI (selective norepinephrine reuptake inhibitors)

Answer 6

–atomexetine (Strattera)

Question 7

SSRIs

Answer 7

• -fluoxetine (Prozac)
• -sertraline (Zoloft)
• -escitalopram (Lexapro)

Question 8

Level 2 Meds:

Answer 8

• -1st-generation & 2nd-generation anti-psychotics
• -mood stabilizers
• -anxiolytics
• -tricyclic antidepressants

Question 9

Methylphenidate

Answer 9

–Ritalin, Concerta, Metadate, Ritalin LA, Focalin XR, Daytrana

Question 10

Amphetamine

Answer 10

–Dexedrine Spansules, Adderall XR, Vyvanse

Question 11

1st-Line ADHD drugs

Answer 11

1) Methylphenidate

2) Amphetamine-based

Question 12

2nd-Line ADHD Drugs

Answer 12

1) SNRIs

2) Adrenergic agonist

Question 13

Disruptive behavior disorders (2)

Answer 13

1) ODD

2) CD

Question 14

Drugs for disruptive behavior disorders

Answer 14

1) Mood stabilizers

2) Atypical antipsychotics

Question 15

Atypical antipsychotics (4)

Answer 15

1) Risperidone
2) Seroquel (Quetiapine)
3) Zyprexa (olanzapine)
4) Abilify (Aripiprazole)

Question 16

tx for major depressive disorders

Answer 16

1) Tricyclics (Level 2 med)

2) fluoxetine (Prozac)

Question 17

what is only FDA-approved antidepressant?

Answer 17

fluoxetine (Prozac)

….(Level 1 med)

Question 18

anxiety tx’s

Answer 18

--SSRI has most evidence:
Sertraline (Zoloft): 6 and up
Fluoxetine (Prozac): 7 and up (depending on condition)
Escitalopram (Lexapro): 12 and up
--in combo w/ CBT

Question 19

PTSD tx

Answer 19

• -Propanolol (no med has FDA approval)

- -some use of SSRIs

Question 20

bipolar disease tx

Answer 20

1) Lithium (12 and up)
2) Atypical antipsychotics (10-17 yrs):
Aripaprazole (Abilify) & respirodone
3) Anticonvulsants (off label)

Question 21

Anticonvulsants

Answer 21

• -Divalproic acid
• -Carbamazepine (Tegretol)
• -Oxcarbazepine (trileptal)
• -Lamotrigine (Lamictal)