Title Information
Title
Psychopharmacological Treatment in Very Young Children with Severe Psychopathology: A Descriptive Study of Use and Adverse Effects
Abstract
Objectives: Psychotropic medication prescription rates for preschool age children are steadily increasing, despite underrepresentation of this age group in literature and the higher risk of adverse drug events (AE). A previous Bradley Hospital Pediatric Partial Hospital Program study found that fluoxetine was the most frequently AE-associated antidepressant (41.2%), followed by stimulants (methylphenidate: 22.7%; mixed amphetamine salts: 21.4%). This follow-up study aimed 1) to describe psychotropic medication use in this early childhood partial hospital program and 2) to characterize parent-reported AE of antidepressants and antipsychotics. Methods: Participants were 172 children (131 males; age 3 to 7 years) admitted to the Pediatric Partial Hospital Program for severe emotional and behavioral problems as indicated by Child Behavior Checklist (CBCL) scores significantly above the clinical cutoff (71.3 ± 9.7 [1.5-5 years], 70.5 ± 7.3 [6-18 years]). A medication tracking form was completed for each participant by a psychiatric nurse and reviewed by the program psychiatrist, documenting medication changes over the course of admission. A retrospective chart review was conducted to document parent-reported AE. Results: Most participants (78%) were prescribed psychiatric medications, most frequently 1) alpha-agonists (58%); 2) antidepressants (46%); and 3) atypical antipsychotics (25%). Fluoxetine was the most frequently AE-associated antidepressant (40%), and risperidone was the only AE-associated antipsychotic (21%). Increased impulsivity was the most frequently reported AE for both antidepressants (44%) and risperidone (29%). Once AE were identified, antidepressants and risperidone were frequently stopped (89%; 57%). Conclusions: This study is among the first to address AE of frequently prescribed antidepressants and antipsychotics in a preschool age children with severe psychopathology. The results support previous findings on AE in this vulnerable population and have important implications for psychotropic medication management. We plan to pilot a structured AE monitoring form to compare structured and spontaneous AE reporting, and predict that the form will capture AE more frequently.
Name
Name Part
Lee, Erica
Role
Role Term (marcrelator) (authorityURI="http://id.loc.gov/vocabulary/relators", valueURI="http://id.loc.gov/vocabulary/relators/aut")
Author
Name
Name Part
Davis, Thamara
Role
Role Term (marcrelator) (authorityURI="http://id.loc.gov/vocabulary/relators", valueURI="http://id.loc.gov/vocabulary/relators/aut")
Author
Name
Name Part
Mernick, Lauren
Role
Role Term (marcrelator) (authorityURI="http://id.loc.gov/vocabulary/relators", valueURI="http://id.loc.gov/vocabulary/relators/aut")
Author
Name
Name Part
DeMarco, Mia
Role
Role Term (marcrelator) (authorityURI="http://id.loc.gov/vocabulary/relators", valueURI="http://id.loc.gov/vocabulary/relators/aut")
Author
Name
Name Part
Martin, Sarah
Role
Role Term (marcrelator) (authorityURI="http://id.loc.gov/vocabulary/relators", valueURI="http://id.loc.gov/vocabulary/relators/aut")
Author
Name
Name Part
Boekamp, John
Role
Role Term (marcrelator) (authorityURI="http://id.loc.gov/vocabulary/relators", valueURI="http://id.loc.gov/vocabulary/relators/aut")
Author
Name
Name Part
Hunt, Jeffrey
Role
Role Term (marcrelator) (authorityURI="http://id.loc.gov/vocabulary/relators", valueURI="http://id.loc.gov/vocabulary/relators/aut")
Author
Name: Corporate
Name Part
Brown University. Alpert Medical School. Scholarly Concentration Program. Non-Scholarly Concentrator
Role
Role Term: Text
research program
Subject (fast) (authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/01081840")
Topic
Psychotropic drugs--Side effects
Subject (fast) (authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/01081659")
Topic
Psychopharmacology
Subject (fast) (authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/01081826")
Topic
Psychotropic drugs
Subject (fast) (authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/00623770")
Topic
American Academy of Child and Adolescent Psychiatry
Subject (fast) (authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/00854531")
Topic
Child psychiatry
Subject (fast) (authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/01054026")
Topic
Partial hospitalization
Subject (fast) (authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/00898912")
Topic
Drugs--Side effects
Subject (fast) (authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/01075582")
Topic
Preschool children
Language
Language Term: Text (ISO639-2B)
English
Origin Information
Date Created (keyDate="yes", encoding="w3cdtf")
2018
Note (displayLabel="Scholarly concentration")
Non-Scholarly Concentrator
Access Condition: use and reproduction (href="")
All rights reserved
Access Condition: logo (href="")
Type of Resource
text