Psychiatric Medications for Children & Adolescents Lynn Baer, RN, MSN, CS

Overview of Presentation Current Statistics Stimulants Antidepressants Anxiety medications Mood Stabilizers Antipsychotics

Prevalence of Mental Illness Among Children & Adolescents At any one time, about 20% of U.S. children & adolescents have at least one diagnosable mental illness (about half of those have illnesses severe enough to cause some level of impairment). Fewer than one in five of these children receives treatment.

Psychiatric Medication Use Among Children & Adolescents Six – eight million children take medications for mental health problems on any given day (about 8 – 10% of the population aged 0 – 18) Office visits resulting in prescriptions of a psychiatric medication among adolescents increased 250% from 1994 - 2001

Stimulants Prescribed for ADHD Benefits: increases focus, reduces motor activity & impulsivity Short-acting, does not build up in the body Controlled substance with potential for abuse

Stimulants Ritalin Focalin Metadate CD Concerta Daytrana patch Adderall Adderall XR Vyvanse Dexadrine Cylert

Side Effects of Stimulants Loss of appetite Irritability Trouble falling asleep

Other meds. For ADHD Strattera Tenex, Intuniv, Clonidine Wellbutrin

Antidepressants Prescribed for depression, anxiety, eating disorders Benefits: elevates mood, reduces anxiety Medication must be taken daily as prescribed to build up in the body in order to see full benefits

Antidepressants Selective Serotonin Reuptake Inhibitors (SSRI’s) Prozac Zoloft Paxil Celexa Lexapro Luvox May take up to 6 wks to see full effect. Difficult to overdose, less side effects than older meds.

Side Effects of SSRI’s Nausea, diarrhea, dry mouth Nervousness, dizziness Sedation or insomnia Increased or decreased appetite Avoid alcohol use

Antidepressants Novel Antidepressants Wellbutrin Effexor Desyrel Serzone Remeron Cymbalta Side effects similar to SSRI’s. Safety, effectiveness in children under 18 has not been established.

Anxiety Medications Benzodiazepines: Xanax, Ativan, Valium May be given for panic, phobias on temporary basis. May be habit forming & can cause sedation, incoordination, headache, confusion. Atypical Anxiolytic: Buspar Given for anxiety disorders. May cause drowsiness, dizziness, headaches.

Mood Stabilizers Prescribed for bipolar disorder Benefit: stabilizes mood May take 1-3 months to see full benefit Treatment may include a combination of mood stabilizers, antipsychotics, antidepressants, and/or stimulants

Mood Stabilizers Lithium Requires blood monitoring Side effects: drowsiness, nausea, vomiting, diarrhea, thirst, weight gain Anticonvulsants: Depakote, Tegretol, Lamictal, Trileptal, Topamax, Neurontin Some require blood monitoring Side effects: drowsiness, dizziness, nausea, vomiting, headache, nervousness

Antipsychotics Prescribed for bipolar disorder, autism, psychosis, aggression, sleep, obsessions Benefits: decreased hallucinations, delusions, increased clear, logical thinking, increased socialization, sedation, increased flexibility Newer antipsychotics have fewer side effects and may work as well on symptoms

Antipsychotics Risperdal Zyprexa Seroquel Abilify Geodon Invega Clozaril

Antipsychotics Side effects: sedation or insomnia, agitation, dry mouth, blurred vision, constipation, nausea, motor inhibition, weight gain, and possibility of muscle rigidity, tremors, drooling, involuntary movement of body parts