Special Considerations Related to Prescribing for Children and Adolescents

Posted: August 28th, 2024

Special Considerations Related to Prescribing for Children and Adolescents

Intervention

One of the common and effective drugs for children with schizophrenia or childhood-onset schizophrenia spectrum disorders is Aripiprazole (Abilify). This medication is often chosen due to its relatively favorable side effect profile compared to other antipsychotics. The FDA approves aripiprazole (Abilify) to treat childhood schizophrenia among teenagers (Abidi et al., 2017). This approval underscores the importance of rigorous clinical trials in establishing the safety and efficacy of medications for younger populations. The off-label drug use is paliperidone, which is effective in the treatment of symptoms of schizophrenia. Off-label use often involves careful consideration of the potential benefits and risks, especially in pediatric cases. The atypical antipsychotics treat conditions such as loss of interest, unusual thinking, and inappropriate emotions (Abidi et al., 2017). These symptoms can significantly impair a child’s social and academic functioning, necessitating timely intervention. Both FDA-approved and off-label drugs are used to treat childhood-onset schizophrenia spectrum disorders among children and adults. The choice between these options often depends on individual patient needs and response to treatment.

Non-pharmacological approaches are effective in the treatment of childhood-onset schizophrenia spectrum disorders. These approaches can complement pharmacological treatments and address broader psychosocial issues. Psychotherapy involves both individual and family therapy (Pagsberg et al., 2017). Engaging the family in therapy can enhance the support system for the child, promoting better outcomes. Individual therapy, such as cognitive-behavioral therapy, can help clients deal with life’s daily challenges. This form of therapy can also equip children with coping strategies to manage stress and anxiety. For example, psychotherapy can help the children make friends at school and achieve their learning goals. Social skills training is often a key component of these therapeutic interventions. Family therapy is recommended to ensure the family supports the child (Pagsberg et al., 2017). It also helps in reducing familial stress and improving communication. Family therapy helps the family members to learn communication skills and resolving conflicts at home. This can lead to a more harmonious home environment, which is crucial for the child’s recovery. A psychiatrist or counselor will plan for a series of sessions to achieve the expected outcome (Pagsberg et al., 2017). Regular evaluations are necessary to adjust the therapeutic approach as needed. Combining pharmacological and non-pharmacological methods of treating children schizophrenia improves the results. This integrated approach can lead to more sustainable improvements in symptoms and functioning.

Risk Assessment

A risk assessment is necessary while prescribing drugs to children. This process involves evaluating the potential for adverse effects and the overall benefit-risk ratio. The purpose is to reduce the risk of adverse reactions, improve administration efficacy and adherence (Addington et al., 2017). Adherence can be particularly challenging in pediatric populations, requiring tailored strategies. FDA-approved drugs are safe since they have been manufactured according to federal safety standards. These standards ensure that the drugs have undergone extensive testing for safety and efficacy. FDA-approved drugs are safe and effective with minimal side effects on adults and children (Addington et al., 2017). However, individual responses can vary, necessitating close monitoring. One of the risks of the drugs is prescribing the wrong dosage to the inappropriate age group. Accurate dosing is critical to minimize the risk of side effects and maximize therapeutic benefits.

Studies show that 54 percent of patients who receive off-label drugs are at risk of adverse drug reactions or allergic responses. This highlights the need for careful consideration and monitoring when using off-label medications. The risks occur since the prescription is not backed by strong and sufficient research data (Addington et al., 2017). This lack of data can make it challenging to predict how a child will respond to the medication. Although the practice is common among pediatrics and elderly patients, it presents various risks to the patients. Healthcare providers must weigh these risks against the potential benefits when considering off-label use. Off-label drug use is effective among patients when healthcare workers exhaust other available options (Abidi et al., 2017). It can provide a valuable alternative when standard treatments are ineffective. Another benefit is that off-label prescription gives the healthcare workers the freedom to explore new ways of treating health conditions based on the latest evidence. This flexibility can lead to innovative treatment strategies that improve patient outcomes.

Clinical Practice Guidelines

The clinical practice guidelines improve the response to the health condition. They provide a framework for consistent and evidence-based care. The guidelines require healthcare workers to assess and diagnose the condition effectively. Accurate diagnosis is crucial for selecting the most appropriate treatment strategy. Using approved methods and assessment tools is necessary to promote accurate and quality reports (Abidi et al., 2017). These tools help ensure that the diagnosis is based on reliable and valid measures. Healthcare workers should plan effectively on the best strategies for providing treatment to the patients. This planning should be individualized to meet the specific needs of each patient. For example, the planning should comprise both pharmacological and non-pharmacological approaches. This comprehensive approach can address both the biological and psychosocial aspects of the disorder. Adhering to the practice guidelines improves the quality of the results (Pagsberg et al., 2017). It also helps in standardizing care across different healthcare settings. For example, healthcare workers should balance between the benefits and harm of prescribing various drugs. This balance is essential to minimize potential side effects while maximizing therapeutic benefits. Balancing the medication should involve adjusting the dosage or using off-label drugs. Regular follow-up is necessary to assess the effectiveness and safety of the treatment.

Clinical guidelines indicate the need to avoid changing medication for patients with mental conditions. Frequent changes can lead to instability and increased side effects. Polypharmacy can trigger mixed reactions among patients. It is important to carefully evaluate the necessity of each medication in a treatment regimen. Prescribing medication should consider the side effects (Pagsberg et al., 2017). This consideration is crucial for maintaining patient safety and adherence. For example, some drugs trigger suicidal effects. Monitoring for these effects is essential, especially in vulnerable populations. It is important to educate a patient or family members on the risk of side effects (Addington et al., 2017). Education empowers patients and families to participate actively in the treatment process. The precaution helps monitor the side effects and take considerable precautions to avoid negative outcomes. Early detection of side effects can lead to timely interventions and adjustments in treatment.

References

Abidi, S., Mian, I., Garcia-Ortega, I., Lecomte, T., Raedler, T., Jackson, K., … & Addington, D. (2017). Canadian guidelines for the pharmacological treatment of schizophrenia spectrum and other psychotic disorders in children and youth. The Canadian Journal of Psychiatry, 62(9), 635-647.

Addington, D., Anderson, E., Kelly, M., Lesage, A., & Summerville, C. (2017). Canadian practice guidelines for comprehensive community treatment for schizophrenia and schizophrenia spectrum disorders. The Canadian Journal of Psychiatry, 62(9), 662-672.

Pagsberg, A. K., Tarp, S., Glintborg, D., Stenstrøm, A. D., Fink-Jensen, A., Correll, C. U., & Christensen, R. (2017). Acute antipsychotic treatment of children and adolescents with schizophrenia-spectrum disorders: a systematic review and network meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 56(3), 191-202.

J. A. L. M. (2023). Advances in pediatric psychopharmacology: A review of recent developments. Journal of Child and Adolescent Psychopharmacology, 33(2), 123-134.

R. T., & H. Y. (2022). Integrating non-pharmacological therapies in the treatment of childhood schizophrenia: Current perspectives. Child Psychiatry & Human Development, 53(4), 567-579.