scholarly journals Antipsychotic prescribing practice among child psychiatrists and community paediatricians

2010 ◽  
Vol 34 (4) ◽  
pp. 126-129 ◽  
Author(s):  
John Otasowie ◽  
Rachel Duffy ◽  
Jenny Freeman ◽  
Chris Hollis
Keyword(s):  
Children And Adolescents ◽  
Atypical Antipsychotic ◽  
Developmental Disorders ◽  
Child And Adolescent ◽  
Typical Antipsychotic ◽  
Antipsychotic Therapy ◽  
Routine Monitoring ◽  
Prescribing Practice ◽  
Antipsychotic Prescribing ◽  
Child Psychiatrists

Aims and methodAll child and adolescent psychiatrists and community paediatricians in the former Trent Region were surveyed about their antipsychotic prescribing practice during 1 year, including monitoring, and whether they would like consensus guidelines on prescribing and monitoring of antipsychotics in children and adolescents.ResultsThe majority (88%) of child psychiatrists and 33% of paediatricians had prescribed atypical antipsychotics, most commonly risperidone. Only two psychiatrists had prescribed a typical antipsychotic and no paediatrician had done so. Challenging behaviour in developmental disorders was the most common indication for atypicals. Both child psychiatrists and paediatricians prescribed atypicals for non-psychotic developmental disorders, whereas prescribing for psychosis occurred almost exclusively among psychiatrists. Height, weight and blood pressure were routinely monitored, but waist circumference was rarely measured and there was wide variation in the monitoring of other parameters such as blood glucose, prolactin and extrapyramidal side-effects. Three-quarters of the participants felt there was a need for guidance on prescribing and monitoring atypical antipsychotic therapy.Clinical implicationsThe greater prescription of antipsychotics by child and adolescent psychiatrists may reflect differences in case-load and training. Routine monitoring of adverse effects is inconsistent among prescribers. The survey highlights the need for training and guidance on prescribing and monitoring of atypical antipsychotic use in children and adolescents.

scholarly journals "Real World" Atypical Antipsychotic Prescribing Practices in Public Child and Adolescent Inpatient Settings

2002 ◽  
Vol 28 (1) ◽  
pp. 111-121 ◽  
Author(s):  
E. Pappadopulos ◽  
P. S. Jensen ◽  
S. B. Schur ◽  
J. C. MacIntyre ◽  
S. Ketner ◽  
...  
Keyword(s):  
Atypical Antipsychotic ◽  
Real World ◽  
Child And Adolescent ◽  
Prescribing Practices ◽  
Inpatient Settings ◽  
Adolescent Inpatient ◽  
Antipsychotic Prescribing

scholarly journals Acute psychosis followed by fever: Malignant neuroleptic syndrome or viral encephalitis?

2014 ◽  
Vol 71 (6) ◽  
pp. 603-607 ◽  
Author(s):  
Zvezdana Stojanovic ◽  
Zeljko Spiric
Keyword(s):  
Cerebrospinal Fluid ◽  
Neuroleptic Malignant Syndrome ◽  
Atypical Antipsychotic ◽  
Electroconvulsive Therapy ◽  
Viral Encephalitis ◽  
First Episode ◽  
Symptomatic Therapy ◽  
Typical Antipsychotic ◽  
Antipsychotic Therapy ◽  
Idiosyncratic Reaction

Introduction. Neuroleptic malignant syndrome is rare, but potentially fatal idiosyncratic reaction to antipsychotic medications. It is sometimes difficult to diagnose some clinical cases as neuroleptic malignant syndrome and differentiate it from the acute viral encephalitis. Case report. We reported a patient diagnosed with acute psychotic reaction which appeared for the first time. The treatment started with typical antipsychotic, which led to febrility. The clinical presentation of the patient was characterised by the signs and symptoms that might have indicated the neuroleptic malignant syndrome as well as central nervous system viral disease. In order to make a detailed diagnosis additional procedures were performed: electroencephalogram, magnetic resonance imaging of the head, lumbar puncture and a serological test of the cerebrospinal fluid. Considering that after the tests viral encephalitis was ruled out and the diagnosis of neuroleptic malignant syndrome made, antipsychotic therapy was immediately stopped. The patient was initially treated with symptomatic therapy and after that with atypical antipsychotic and electroconvulsive therapy, which led to complete recovery. Conclusion. We present the difficulties of early diagnosis at the first episode of acute psychotic disorder associated with acute febrile condition. Concerning the differential diagnosis it is necessary to consider both neuroleptic malignant syndrome and viral encephalitis, i.e. it is necessary to make the neuroradiological diagnosis and conduct cerebrospinal fluid analysis and blood test. In neuroleptic malignant syndrome treatment a combined use of electroconvulsive therapy and low doses of atypical antipsychotic are confirmed to be successful.

High-dose antipsychotic therapy and reflective prescribing: development of an online tool for rapid, easy calculation of antipsychotic total daily dose

2020 ◽  
Vol 28 (4) ◽  
pp. 410-413
Author(s):  
Korinne Northwood ◽  
Theo Theodoros ◽  
Nancy Wang ◽  
Dan Siskind
Keyword(s):  
Decision Making ◽  
Improve Patient Safety ◽  
Total Daily Dose ◽  
High Dose ◽  
Antipsychotic Therapy ◽  
Daily Dose ◽  
Prescribing Practice ◽  
Dosing Regimens ◽  
Antipsychotic Prescribing ◽  
The Impact

Objective: Safe and effective antipsychotic prescribing is a fundamental skill in psychiatric practice; however, antipsychotic medications are not without risk. These risks are increased when antipsychotics are prescribed in high doses, with or without polypharmacy. Decision-making regarding antipsychotic prescribing can be hampered by a lack of readily available or easily approachable tools for calculating and interpreting total daily doses, especially when antipsychotic polypharmacy is involved. Our objective was to create an accessible method for calculating antipsychotic total daily dosing. Methods: We have developed an online calculator for determining antipsychotic total daily dose using information on recommended maximum total daily dosing based on the British National Formulary. Results: This calculator is free, easy to implement and allows for users to input a large variety of possible antipsychotic dosing regimens. Conclusions: It is hoped that this tool will allow clinicians to readily review their prescribing practice, inform decision-making and improve patient safety outcomes. Further research may be appropriate to determine the impact of this tool on these intended goals.

scholarly journals The Impact of COVID-19 School Closure on Child and Adolescent Health: A Rapid Systematic Review

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 415
Author(s):  
Sonia Chaabane ◽  
Sathyanarayanan Doraiswamy ◽  
Karima Chaabna ◽  
Ravinder Mamtani ◽  
Sohaila Cheema
Keyword(s):  
Systematic Review ◽  
Children And Adolescents ◽  
Adolescent Health ◽  
Children With Disabilities ◽  
Child And Adolescent ◽  
Emergency Department Visits ◽  
School Closure ◽  
School Closures ◽  
Child And Adolescent Health ◽  
The Impact

School closures during pandemics raise important concerns for children and adolescents. Our aim is synthesizing available data on the impact of school closure during the coronavirus disease 2019 (COVID-19) pandemic on child and adolescent health globally. We conducted a rapid systematic review by searching PubMed, Embase, and Google Scholar for any study published between January and September 2020. We included a total of ten primary studies. COVID-19-related school closure was associated with a significant decline in the number of hospital admissions and pediatric emergency department visits. However, a number of children and adolescents lost access to school-based healthcare services, special services for children with disabilities, and nutrition programs. A greater risk of widening educational disparities due to lack of support and resources for remote learning were also reported among poorer families and children with disabilities. School closure also contributed to increased anxiety and loneliness in young people and child stress, sadness, frustration, indiscipline, and hyperactivity. The longer the duration of school closure and reduction of daily physical activity, the higher was the predicted increase of Body Mass Index and childhood obesity prevalence. There is a need to identify children and adolescents at higher risk of learning and mental health impairments and support them during school closures.

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