Peds Psych Flashcards
who has highest risk adverse effects from medications?
kids
Tourettes
tics for >1 year
onset before 18
prevalence of other disease states with tic disorder
ADHD 75 %
OCD 50%
rule of thirds tic disorders
1/3 resolve
1/3 improve
1/3 stay the same
what percent have tic symptoms as adults
10%
first line treatment of tics
alpha 2 agonists
clonidine
guanfacine
second line treatment of tics
atypical antipshchotics
aripiprazole
risperidone
third line treatment of tics
typical antipsychotics
haloperidol
pimozide
aripiprazole FDA approved ij what age and dosing
tics
6-17 years
weight based dosing
stimulant use in tourettes can do what
exacerbate vocal and motor tics
what if cant use stimulant in ADHD due to bad sx of tics
try atomoxetine or tricyclic antidepressant
conduct disorder age specifications
childhood <10 years
adolescent > 10 years
or unspecified
when to consider drug therapy for ODD/CD
adjunct after baseline sx determined
interventions failed
aggression to dangerous levels
first line drugs ODD/CD
stimulants / guanfacine / clonidine
when to use atypical antipsychotics in ODD/CD
severe persisten aggression, serious behaviors or defiance
pts with ADHD and ODD or CD we commonly see with what meds
stimulant and clonidine/guanfacine
separation anxiety mild
psycotherapy
separation anxiety moderate to severe treatment
SSRi - fluoxetine / escitalopram
autism spectrum disorder is defined as
-persistent deficits in social communication and social interaction across multiple contexts
autism spectrum behaviors
resetrictive, repetitive patterns of behavior, interests, activities
symptoms of autism
agression
hyperactivity
inatytyention
irritable
poor frustration tolerance
temper tantrum
OCD
hypersensitivty
medical problems associated with autism spectrum disorder
seizures and GI disorders
medications efficacious in core autism sx
none
first line ASD
applied behavior analysis (ABA)
medications for autism irritability / aggression
6-17: aripiprazole
5-16 risperidone
lamotrigine / levitiracetam effect on irritability
no effect
repetitive behavior treatment
haloperidol, risperidone, aripiprazole
ADHD and autism treatment
methylphenidate
clonidine / guanfacine - irritable/explosive
sleep in autism treatment
melatonin 1-6 mg nightly
what is disruptive mood disorder
severe recurrent temper outbursts that are verbal and are out of pocket for the situation
disruptive mood disorder diagnosis
age 6-17
two settings (home, school, friends)
must be severe in one
DMD - what do we need to rule out
bipolar (antidepresants vs mood stabilizers)
first line DMDD
stimulants and SSRIs
pediatric depression children complaints
physical complaints - irritable, conduct probs, sucidal
pediatric depression adolescnet complaints
more feeling based
pediatric depression, chronic or episodic
chronic, instability may be bipolar
remission rates after CBT in depression
70%
black box warning antidepressants
suicide risk first three months treatment
antidepressant for 8+
fluoxetine
escitalopram ages
12-17
fluoxetine ages
8+
avoid which antidepressant in kids
paroxetine, suicide risk
1st line bipolar in kids
lithium
first like therapy for PTSD
trauma focused psychotherapy
medication treatment for PTSD in kids
SSRIs
citalopram/sertraline
schizophrenia in kids onset age
before 13
visual hallucinations more common in ____
adults
