Innovations in Practice: ‘Off-label’ clonidine: UK Paediatric and Child and Adolescent Psychiatry prescribing practice for sleep problems

2013 ◽  
Vol 19 (2) ◽  
pp. 147-150 ◽  
Author(s):  
Rebecca L. MacLeod ◽  
Daphne V. Keen
Keyword(s):  
Adolescent Psychiatry ◽  
Sleep Problems ◽  
Child And Adolescent ◽  
Child And Adolescent Psychiatry ◽  
Off Label ◽  
Prescribing Practice

scholarly journals Prescribing antipsychotics in child and adolescent psychiatry: guideline adherence

2020 ◽  
Vol 29 (12) ◽  
pp. 1717-1727 ◽  
Author(s):  
Mariken Dinnissen ◽  
Andrea Dietrich ◽  
Judith H. van der Molen ◽  
Anne M. Verhallen ◽  
Ynske Buiteveld ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Adolescent Psychiatry ◽  
Psychosocial Interventions ◽  
Child And Adolescent ◽  
Autism Spectrum ◽  
Child And Adolescent Psychiatry ◽  
Psychosocial Treatment ◽  
Antipsychotic Treatment ◽  
Concomitant Treatment ◽  
Off Label

Abstract Antipsychotics are often prescribed to children and adolescents, mostly off-label. We aimed to assess adherence to recommendations of guidelines for antipsychotic prescription. We reviewed 436 medical records from 155 clinicians from 26 clinics within three Dutch child and adolescent psychiatry organizations (n = 398 outpatient, n = 38 inpatient care). We assessed target symptoms, diagnostic process, prior and concomitant treatment, and consideration of contra-indications. Multiple logistic regression assessed the role of age, sex, and psychiatric diagnosis on adherence to three main recommendations: to (1) prescribe antipsychotics only after other treatments proved insufficient, (2) always combine antipsychotics with psychosocial interventions, and (3) not prescribe multiple antipsychotics simultaneously. Most patients received off-label antipsychotics. Main target symptoms were inattention/hyperactivity (25%), aggression (24%), and other disruptive behaviors (41%). Most patients underwent diagnostic evaluation before the first prescription; however, screening of contra-indications was low (0.2–19%). About 84% had previously received psychosocial treatment and 48% other psychoactive medication, but 9% had not received any treatment. Notably, only 37% continuously received concomitant psychosocial treatment. Simultaneous use of multiple antipsychotics occurred in 3.2%. Younger children were at higher risk of non-adherence to guideline recommendations regarding prior and concomitant treatment, children with autism spectrum disorder or attention-deficit/hyperactivity disorder more likely not to receive concomitant psychosocial treatment. Sex did not significantly affect adherence. Our findings implicate insufficient adherence to important recommendations regarding antipsychotic use in children and adolescents. Especially younger children are at higher risk of receiving suboptimal care. There is an urgency to consistently offer psychosocial interventions during antipsychotic treatment.

Off-Label Prescription of Psychopharmacological Drugs in Child and Adolescent Psychiatry

2016 ◽  
Vol 36 (5) ◽  
pp. 500-507 ◽  
Author(s):  
Julie Vestergaard Braüner ◽  
Lily Manzello Johansen ◽  
Troels Roesbjerg ◽  
Anne Katrine Pagsberg
Keyword(s):  
Adolescent Psychiatry ◽  
Child And Adolescent ◽  
Child And Adolescent Psychiatry ◽  
Off Label

Handbook for Trainees in Child and Adolescent Psychiatry and Psychology

PsycCRITIQUES ◽  
2007 ◽  
Vol 52 (43) ◽  
Author(s):  
Marios Constantinou ◽  
Margarita Kapsou ◽  
Maria Karekla
Keyword(s):  
Adolescent Psychiatry ◽  
Child And Adolescent ◽  
Child And Adolescent Psychiatry
Sign in / Sign up

Export Citation Format

Share Document