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  1. Alprazolam is an antianxiety agent, benzodiazepines. Used primarily for short-term relief of mild to moderate anxiety and nervous tension. Alprazolam is also effective in the treatment of activity depression or panic attacks. It can be useful in treating irritable bowel syndrome and anxiety due to a neurosis as well. Alprazolam may help the symptoms of PMS if extreme, some cancers pains if given with various narcotics, agoraphobia, essential tremor, and ringing ears. CLASS: Triazolo Benzodiazepines. Generic name: Alprazolam. Type: Antianxiety. Strengths: Oral Solution: 0.25mg , 0.5 mg 1 mg / 5 ml, 0.25mg / 2.5 ml. Tables: 0.25mg, 0.5 mg, 1 mg, 2 mg. Dosages: Actual dosage must be determined by a physician. Normal dosage: USE UP TO EIGHT MONTHS ONLY! If under 18 years of age, DO NOT USE! 18 to 60 years of age, 0.25mg to 1.5mg daily. Over 60 years of age, Lower dosage increased cautiously. Dosage Depends on Disorder: Oral ( For anxiety or nervous tension ): Start : 0.25 mg to 0.5 mg 3 times daily. Maximum : 4 mg in 24 hours. Oral ( For panic disorder ): Start : 0.5 mg 3 times daily. Increases : 1 mg daily in 3 to 4 day intervals. Maximum : 10 mg in 24 hours. Problems with: Liver Function: If liver disease present, start dosage at 0.25mg, increase as needed. Kidney Function: N/A. Test: Before taking: None if for short term use. While taking: None if for short term use. Take With: With or without food. Full Benefits In: First day to a week. Missed Dose(s): If within one hour take, if over an hour skip and then continue on your normal schedule. Never Take a Double Dose! If Stop Taking: Do not stop without consulting your physician and never abruptly if have been taking for over three weeks. Overdose symptoms include: Confusion, loss of consciousness, or sleepiness. Can be fatal. -------------------------------------------------------------------------------- Warnings Do not stop taking abruptly. Do not give this drug to anyone who is psychotic. Narcotics may increase the sedative effects of this drug. Do not take other sedative, benzodiazepines, or sleeping pills with this drug. The combinations could be fatal. Do not drink alcohol when taking benzodiazepines. Alcohol can lower blood pressure and decrease your breathing rate to the point of unconsciousness. The habit-forming potential is high. It is possible to become dependent in the first few days. Do not stop taking this drug abruptly, this could cause psychological and physical withdrawal symptoms. Do not use if: Do not use this drug if you had negative reactions to other benzodiazepines. Do not use this drug if you have a history of drug dependence. Do not use this drug if you have had a stroke. Do not use this drug if you have multiple sclerosis. Do not use this drug if you have Alzheimer's disease. Do not use this drug if you are seriously depressed or if you have other brain disorders. Do not use this drug if you have myasthenia gravis or acute narrow-angle glaucoma. Do not use this drug if you are pregnant or planning to become pregnant. Do not use this drug if you are breast-feeding. Do not use this drug if under eighteen and only in small doses if over sixty with very close monitoring. Inform Physician If: If you have a seizure disorder, impaired liver / kidney function, history of alcoholism / drug abuse, psychosis, palpitations, or Tachycardia. -------------------------------------------------------------------------------- Alprazolam ( Symptoms or Effects ) Common: Clumsiness / Sleepiness. Rare: Abdominal cramps, blurred vision, dry mouth, racing heartbeat / palpitations, shaking / slurred speech, urination problems, convulsions, hallucinations, memory loss, trouble breathing, staggering / trembling, headache, confusion, sore breast / milk secretion, or irregular menstruation. See physician always: Abdominal cramps, blurred vision, dry mouth, racing heartbeat / palpitations, shaking / slurred speech, urination problems, convulsions, hallucinations, memory loss, trouble breathing, staggering / trembling, headache, confusion, sore breast / milk secretion, or irregular menstruation. See physician if severe: Clumsiness / Sleepiness. See physician NOW: Convulsions, hallucinations, memory loss, trouble breathing, or staggering / trembling. =========================================================== National Library of Medicine: http://druginfo.nlm.nih.gov/drugportal/drugportal.jsp HALOPERIDOL (HALOPERIDOL) http://druginfo.nlm.nih.gov/drugportal/ProxyServlet?mergeData=true&objectHandle=DBMaint&APPLICATION_NAME=drugportal&actionHandle=default&nextPage=jsp/drugportal/ResultScreen.jsp&TXTSUPERLISTID=0000052868&QV1=HALOPERIDOL Haloperidol pronounced as (ha loe per' i dole) Why is this medication prescribed? How should this medicine be used? Other uses for this medicine What special precautions should I follow? What special dietary instructions should I follow? What should I do if I forget a dose? What side effects can this medication cause? What should I know about storage and disposal of this medication? In case of emergency/overdose What other information should I know? Brand names IMPORTANT WARNING: Studies have shown that older adults with dementia (a brain disorder that affects the ability to remember, think clearly, communicate, and perform daily activities and that may cause changes in mood and personality) who take antipsychotics (medications for mental illness) such as haloperidol have an increased chance of death during treatment. Haloperidol is not approved by the Food and Drug Administration (FDA) for the treatment of behavior problems in older adults with dementia. Talk to the doctor who prescribed this medication if you, a family member, or someone you care for has dementia and is taking haloperidol. For more information, visit the FDA website: http://www.fda.gov/Drugs Why is this medication prescribed? Haloperidol is used to treat psychotic disorders (conditions that cause difficulty telling the difference between things or ideas that are real and things or ideas that are not real). Haloperidol is also used to control motor tics (uncontrollable need to repeat certain body movements) and verbal tics (uncontrollable need to repeat sounds or words) in adults and children who have Tourette's disorder (condition characterized by motor or verbal tics). Haloperidol is also used to treat severe behavioral problems such as explosive, aggressive behavior or hyperactivity in children who cannot be treated with psychotherapy or with other medications. Haloperidol is in a group of medications called conventional antipsychotics. It works by decreasing abnormal excitement in the brain. How should this medicine be used? Haloperidol comes as a tablet and concentrated liquid to take by mouth. It is usually taken two or three times a day. Take haloperidol at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take haloperidol exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Your doctor will probably start you on a low dose of haloperidol and gradually increase your dose. Your doctor may decrease your dose once your condition is controlled. Be sure to tell your doctor how you are feeling during your treatment with haloperidol. Haloperidol may help control your condition, but will not cure it. Continue to take haloperidol even if you feel well. Do not stop taking haloperidol without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop taking haloperidol, you may experience difficulty controlling your movements. Other uses for this medicine Haloperidol is also used to treat confusion and difficulty thinking and understanding that is caused by severe physical or mental illness. Talk to your doctor about the possible risks of using this medication for your condition. This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. What special precautions should I follow? Before taking haloperidol, tell your doctor and pharmacist if you are allergic to haloperidol or any other medications. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: amiodarone (Cordarone); anticoagulants (blood thinners); antihistamines; disopyramide (Norpace); dofetilide (Tikosyn); epinephrine (Epipen); erythromycin (E.E.S., E-Mycin, Erythrocin); ipratropium (Atrovent); lithium (Eskalith, Lithobid); medications for anxiety, depression, irritable bowel disease, mental illness, motion sickness, Parkinson's disease,seizures, ulcers, or urinary problems; methyldopa; moxifloxacin (Avelox); narcotic medications for pain; pimozide (Orap); procainamide ; quinidine ; rifampin (Rifater, Rifadin); sedatives; sotalol (Betapace, Betapace AF); sparfloxacin (Zagam) (not available in the US); sleeping pills; thioridazine; and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. tell your doctor if you have or have ever had Parkinson's disease (PD; a disorder of the nervous system that causes difficulties with movement, muscle control, and balance). Your doctor will probably tell you not to take haloperidol. tell your doctor if you or anyone in your family has or has ever had prolonged QT syndrome (condition that increases the risk of developing an irregular heartbeat that may cause loss of consciousness, or sudden death). Also tell your doctor if you have or have ever had breast cancer; bipolar disorder (condition that causes episodes of depression, episodes of mania, and other abnormal moods); citrullinemia (condition that causes build-up of ammonia in the blood); an abnormal electroencephalogram (EEG; a test that records electrical activity in the brain); seizures; an irregular heartbeat; low levels of calcium or magnesium in your blood; chest pain; or heart or thyroid disease. Also tell your doctor if you have ever had to stop taking a medication for mental illness due to severe side effects. tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, or if you plan to become pregnant or are breast-feeding. If you become pregnant while taking haloperidol, call your doctor. Haloperidol may cause problems in newborns following delivery if it is taken during the last months of pregnancy. if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking haloperidol. you should know that this medication may make you drowsy and may affect your thinking and movements. Do not drive a car or operate machinery until you know how this medication affects you. ask your doctor about the safe use of alcohol during your treatment with haloperidol. Alcohol can make the side effects of haloperidol worse. What special dietary instructions should I follow? Unless your doctor tells you otherwise, continue your normal diet. What should I do if I forget a dose? Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. What side effects can this medication cause? Haloperidol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: drowsiness dry mouth increased saliva blurred vision loss of appetite constipation diarrhea heartburn nausea vomiting difficulty falling asleep or staying asleep blank facial expression uncontrollable eye movements unusual, slowed, or uncontrollable movements of any part of the body restlessness agitation nervousness mood changes dizziness headache breast enlargement or pain breast milk production missed menstrual periods decreased sexual ability in men increased sexual desire difficulty urinating If you experience any of the following symptoms, call your doctor immediately: fever muscle stiffness confusion fast or irregular heartbeat sweating decreased thirst neck cramps tongue that sticks out of the mouth tightness in the throat difficulty breathing or swallowing fine, worm-like tongue movements uncontrollable, rhythmic face, mouth, or jaw movements seizures eye pain or discoloration decreased vision, especially at night seeing everything with a brown tint rash yellowing of the skin or eyes erection that lasts for hours Haloperidol may cause other side effects. Tell your doctor if you have any unusual problems while you are taking this medication. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). What should I know about storage and disposal of this medication? Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Protect the liquid from light and do not allow it to freeze. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication. In case of emergency/overdose In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911. Symptoms of overdose may include: unusual, slowed, or uncontrollable movements of any part of the body stiff or weak muscles slowed breathing sleepiness loss of consciousness What other information should I know? Keep all appointments with your doctor. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. Brand names Haldol®¶ ¶ This branded product is no longer on the market. Generic alternatives may be available. Last Revised - 05/16/2011 Browse Drugs and Medicines American Society of Health-System Pharmacists, Inc. Disclaimer AHFS® Patient Medication Information. © Copyright, 2016. The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP. ====================================================== RISPERDAL (RISPERIDONE) http://druginfo.nlm.nih.gov/drugportal/ProxyServlet?mergeData=true&objectHandle=DBMaint&APPLICATION_NAME=drugportal&actionHandle=default&nextPage=jsp/drugportal/ResultScreen.jsp&TXTSUPERLISTID=0106266062&QV1=RISPERDAL Risperidone pronounced as (ris per' i done) Why is this medication prescribed? How should this medicine be used? Other uses for this medicine What special precautions should I follow? What special dietary instructions should I follow? What should I do if I forget a dose? What side effects can this medication cause? What should I know about storage and disposal of this medication? In case of emergency/overdose What other information should I know? Brand names IMPORTANT WARNING: Studies have shown that older adults with dementia (a brain disorder that affects the ability to remember, think clearly, communicate, and perform daily activities and that may cause changes in mood and personality) who take antipsychotics (medications for mental illness) such as risperidone have an increased risk of death during treatment. Older adults with dementia may also have a greater chance of having a stroke or ministroke during treatment. Tell your doctor and pharmacist if you are taking furosemide (Lasix). Risperidone is not approved by the Food and Drug Administration (FDA) for the treatment of behavior problems in older adults with dementia. Talk to the doctor who prescribed this medication if you, a family member, or someone you care for has dementia and is taking risperidone. For more information visit the FDA website: http://www.fda.gov/Drugs Why is this medication prescribed? Risperidone is used to treat the symptoms of schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions) in adults and teenagers 13 years of age and older. It is also used to treat episodes of mania (frenzied, abnormally excited, or irritated mood) or mixed episodes (symptoms of mania and depression that happen together) in adults and in teenagers and children 10 years of age and older with bipolar disorder (manic depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods). Risperidone is also used to treat behavior problems such as aggression, self-injury, and sudden mood changes in teenagers and children 5 to 16 years of age who have autism (a condition that causes repetitive behavior, difficulty interacting with others, and problems with communication). Risperidone is in a class of medications called atypical antipsychotics. It works by changing the activity of certain natural substances in the brain. How should this medicine be used? Risperidone comes as a tablet, a solution (liquid), and an orally disintegrating tablet (tablet that dissolves quickly in the mouth) to take by mouth. It is usually taken once or twice a day with or without food. Take risperidone at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take risperidone exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Use the dropper provided to measure your dose of risperidone oral solution. You can take the oral solution with water, orange juice, coffee, or low-fat milk. Do not take the solution with tea or cola. Do not try to push the orally disintegrating tablet through the foil. Instead, use dry hands to peel back the foil packaging. Immediately take out the tablet and place it on your tongue. The tablet will quickly dissolve and can be swallowed with or without liquid. Do not chew or crush the tablet. Your doctor will probably start you on a low dose of risperidone and gradually increase your dose to allow your body to adjust to the medication. Risperidone may help control your symptoms but will not cure your condition. It may take several weeks or longer before you feel the full benefit of risperidone. Continue to take risperidone even if you feel well. Do not stop taking risperidone without talking to your doctor. If you suddenly stop taking risperidone, your symptoms may return and your illness may become harder to treat. Other uses for this medicine This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. What special precautions should I follow? Before taking risperidone, tell your doctor and pharmacist if you are allergic to risperidone or any other medications. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements and herbal products you are taking or plan to take. Be sure to mention any of the following: antidepressants; carbamazepine (Tegretol); cimetidine (Tagamet); clozapine (Clozaril); dopamine agonists such as bromocriptine (Parlodel), cabergoline (Dostinex), levodopa (Dopar, Larodopa), pergolide (Permax), and ropinirole (Requip); medications for anxiety, high blood pressure, or seizures; other medications for mental illness; paroxetine (Paxil); phenobarbital (Luminal, Solfoton); phenytoin (Dilantin); quinidine (Quinaglute, Quinidex); ranitidine (Zantac); rifampin (Rifadin, Rimactane); sedatives; sleeping pills; tranquilizers; and valproic acid (Depakote, Depakene). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. tell your doctor if you use or have ever used street drugs or large amounts of alcohol; if you have ever overused prescription medications; if you have or have ever had Parkinson's disease (PD; a disorder of the nervous system that causes difficulties with movement, muscle control, and balance); dyslipidemia (high cholesterol levels); a low level of white blood cells in your blood or a decrease in white blood cells; difficulty swallowing; breast cancer; angina (chest pain); irregular heartbeat; high or low blood pressure; heart failure; a heart attack; a stroke; seizures; heart, kidney or liver disease; or if you or anyone in your family has or has ever had diabetes. Also tell your doctor if you have ever had to stop taking a medication for mental illness because of severe side effects. Tell your doctor if you have severe vomiting or diarrhea or signs of dehydration now, or if you develop these symptoms at any time during your treatment. tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, or if you plan to become pregnant or are breastfeeding. If you become pregnant while taking risperidone, call your doctor. Risperidone may cause problems in newborns following delivery if it is taken during the last months of pregnancy. if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking risperidone. you should know that risperidone may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you. you should know that alcohol can add to the drowsiness caused by this medication. Do not drink alcohol while taking risperidone. you should know that you may experience hyperglycemia (increases in your blood sugar) while you are taking this medication, even if you do not already have diabetes. If you have schizophrenia, you are more likely to develop diabetes than people who do not have schizophrenia, and taking risperidone or similar medications may increase this risk. Tell your doctor immediately if you have any of the following symptoms while you are taking risperidone: extreme thirst, frequent urination, extreme hunger, blurred vision, or weakness. It is very important to call your doctor as soon as you have any of these symptoms, because high blood sugar that is not treated can cause a serious condition called ketoacidosis. Ketoacidosis may become life-threatening if it is not treated at an early stage. Symptoms of ketoacidosis include dry mouth, upset stomach and vomiting, shortness of breath, breath that smells fruity, and decreased consciousness. you should know that risperidone may make it harder for your body to cool down when it gets very hot or warm up when it gets very cold. Tell your doctor if you plan to do vigorous exercise or be exposed to extremely high or low temperatures. you should know that risperidone may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. This is more common when you first start taking risperidone. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up. if you have phenylketonuria (PKU, an inherited condition in which a special diet must be followed to prevent mental retardation), you should know that the orally disintegrating tablets contain phenylalanine. What special dietary instructions should I follow? Unless your doctor tells you otherwise, continue your normal diet. What should I do if I forget a dose? Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. What side effects can this medication cause? Risperidone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: nausea vomiting diarrhea constipation heartburn dry mouth increased saliva increased appetite weight gain stomach pain anxiety agitation restlessness dreaming more than usual difficulty falling asleep or staying asleep breast enlargement or discharge late or missed menstrual periods decreased sexual ability vision problems muscle or joint pain dry or discolored skin difficulty urinating Some side effects can be serious. If you experience any of the following symptoms or those listed in the IMPORTANT WARNING section or the SPECIAL PRECAUTIONS section, call your doctor immediately: fever muscle stiffness confusion fast or irregular pulse sweating unusual movements of your face or body that you cannot control faintness seizures slow movements or shuffling walk rash hives itching difficulty breathing or swallowing painful erection of the chicken that lasts for hours Risperidone may cause children to gain more weight than expected and for boys and male teenagers to have an increase in the size of their breasts. Talk to your doctor about the risks of giving this medication to your child. Risperidone may cause other side effects. Call your doctor if you have any unusual problems while taking this medication. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). What should I know about storage and disposal of this medication? Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Always store the orally disintegrating tablets in their sealed package, and use them immediately after opening the package. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication. In case of emergency/overdose In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911. Symptoms of overdose may include the following: drowsiness fast, pounding, or irregular heartbeat upset stomach blurred vision fainting dizziness seizures What other information should I know? Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to risperidone. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. Brand names Risperdal® Oral Solution Risperdal® Tablets Risperdal® M-TAB® Orally Disintegrating Tablets Last Revised - 11/15/2015 Browse Drugs and Medicines American Society of Health-System Pharmacists, Inc. Disclaimer AHFS® Patient Medication Information. © Copyright, 2016. The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.
  2. Today in JAMA Pediatrics, researchers from The Children's Hospital of Philadelphia's (CHOP) PolicyLab published the largest study to date documenting the significant risks to children's health associated with prescription antipsychotics, a powerful a class of medications used to treat mental and behavioral health disorders. The results suggest that initiating antipsychotics may elevate a child's risk not only for significant weight gain, but also for type II diabetes by nearly 50 percent; moreover, among children who are also receiving antidepressants, the risk may double. Previous PolicyLab research showed that one in three youth receiving antidepressants in the Medicaid program were receiving an antipsychotic at the same time. Traditionally, antipsychotics have been narrowly prescribed to children with a diagnosis of schizophrenia or bipolar disorder, or to those with significant developmental delays who were displaying aggressive behaviors that were potentially injurious to themselves or others. However, in recent years, these medications are increasingly being prescribed in the absence of strong supporting safety and efficacy data to treat healthier children and adolescents with disruptive behaviors, such as those who are diagnosed with attention deficit hyperactivity disorder (ADHD). The new study, which used national Medicaid data on more than 1.3 million youth ages 10 to 18 with a mental health diagnosis from the Centers for Medicare and Medicaid Services, must be interpreted in the context of emerging evidence that Medicaid-enrolled children are far more likely than privately insured children to be prescribed antipsychotic medications. Overall, over 25 percent of Medicaid-enrolled children receiving prescription medications for behavioral problems were prescribed antipsychotics by 2008, largely for less severe disorders. "With such vast numbers of children being exposed to these medications, the implications for potential long-lasting harm can be jarring," said David Rubin, MD, MSCE, the study's lead author and co-director of PolicyLab at CHOP. Nevertheless, Rubin and his co-authors remain cautious in over-reacting to these findings. The baseline risk for diabetes among youth who were not exposed to antipsychotics in the study was only 1 in 400, rising to 1 in 260 among those initiating antipsychotics, and at most to 1 in 200 among those who initiated antipsychotics while they were simultaneously receiving antidepressants. "Although these findings should certainly give us pause," Dr. Rubin added, "we should not reflexively over-react to them. Rather, we need to incorporate these new revelations about the risk for diabetes into a more thoughtful consideration of the true risks and benefits of prescribing an antipsychotic to a child. Yes, we should try, by all means possible, to minimize the numbers of children and adolescents exposed to these powerful medications. But for some children in immediate crisis, we must also concede that the benefit of the antipsychotic for acute management may still outweigh the risk." The study's authors recommend that clinicians and families who are making medication decisions periodically revisit the treatment strategy to address challenging behaviors. For example, when planning to prescribe antipsychotics to a child, professional organizations recommend beginning cautiously with the lowest dose possible, while strictly monitoring for early evidence of weight gain or abnormal lab tests that often predict later onset of diabetes. Dr. Rubin, who is also an attending pediatrician at CHOP, notes, "Once a child is on the antipsychotic drug, a plan should be agreed upon and periodically revisited to see whether or not an evidence-based counseling service, such as trauma-focused cognitive therapy, could address underlying emotional trauma, which is often the root cause for the behavior. That same periodic review would also seek to transition the child off the antipsychotic as soon as possible, once these problems are more suitably addressed. " Ultimately, say Rubin and his co-authors, the prescription of antipsychotics to children and adolescents is likely to continue, reflecting a growing demand to address very challenging behaviors in children "At the end of the day, the approach to the individual child who is in crisis is still a case-by-case decision between a family and the treating provider," said Dr. Rubin. "We can only hope that those decisions are made in full recognition of our findings, and that for some children, alternatives to these powerful medications--such as counseling or other supportive services, will be considered first." Source:Children's Hospital of Philadelphia
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