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Routine investigations in paediatric psychopharmacology

Published online by Cambridge University Press:  13 June 2014

Aisling Mulligan ,
Fiona McNicholas  and
Tom Moran
Aisling Mulligan
Affiliation:
Department of Psychiatry, Trinity Centre for Health Sciences, St James's Hospital andTrinity College Dublin, Ireland. Now at the Mater Child Guidance, Mater Misericordiae Hospital and UCD
Fiona McNicholas
Affiliation:
Department of Child and Adolescent Psychiatry, Our Lady's Hospital for Sick Children Crumlin, St John of God's Lucena Clinic Rathgar and University College Dublin, Ireland
Tom Moran
Affiliation:
Department of Child Psychiatry, The National Children's Hospital, Tallaght, Dublin 24, Ireland
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Abstract

Objectives: This study examines (1) what are the minimum accepted baseline investigations recommended in the literature prior to prescribing in child psychiatry and (2) whether these investigations are routinely performed.

Method: Medical literature on prescribing in child and adolescent psychiatry was reviewed, and a list of minimum baseline investigations recommended in the literature was established. A postal survey was performed to establish what current clinical practice is among child and adolescent psychiatrists. Current practice was compared with the recommendations in the literature.

Results: There are nine minimum accepted baseline investigations which are consistently recommended in the literature on child psychiatry. Six investigations are routinely performed by over 75% of respondents. However only 30% (n = 16) reported that they ‘always’ carried out eight or more of the nine recommended minimum investigations.

Conclusions: A consensus statement is necessary, providing a list of recommended investigations prior to prescribing in child and adolescent psychiatry. Continuing medical education can then highlight the importance of these investigations.

Keywords

Paediatric psychopharmacologyPrescribing parametersPrescriptionInvestigationsStimulantsAntidepressantsAntipsychotics
Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 25 , Issue 1 , March 2008 , pp. 11 - 16
Copyright
Copyright © Cambridge University Press 2008

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References

1.Bramble, D. Annotation: The use of psychotropic medications in children: a British view. J Child Psychol Psychiatry 2003; 44: 169–179.CrossRefGoogle ScholarPubMed
2.Safer, DJ, Krager, JM. A survey of medication treatment for hyperactive/inattentive students. JAMA 1988; 260: 2256–2258.CrossRefGoogle ScholarPubMed
3.Pincus, HAet al.Prescribing trends in psychotropic medications: primary care, psychiatry and other medical specialties. JAMA 1998; 279: 526–531.CrossRefGoogle ScholarPubMed
4.British Medical Association, Royal Pharmaceutical Society of Great Britain, Royal College of Paediatrics and Child Health, Neonatal and Paediatric Pharmacists Group. British National Formulary for Children 2006. London: BMJ Publishing Group Ltd.Google Scholar
5.US Food and Drug Administration. Center for Drug Evaluation and Research. 2004 Available: www.fda.gov/cder/grug/antidepressants/SSRIIabelChange.htmGoogle Scholar
6.Taylor, D, Paton, C, Kerwin, R. The South London and Maudsley NHS Trust 2003 Prescribing Guidelines. London: Martin Dunitz, an imprint of the Taylor & Francis Group 2003: 169–171.CrossRefGoogle Scholar
7.Royal College of Paediatrics and Child Health; Neonatal and Paediatric Pharmacists Group. Medicines for Children. London: RCPCH Publications, 2003: 403–404.Google Scholar
8.Hill, P, Taylor, E. An auditable protocol for treating attention deficit/hyperactivity disorder. Arch Dis Child 2001; 84: 404–409.CrossRefGoogle ScholarPubMed
9.National Institutes of Health Consensus Development Conference Statement. Diagnosis and Treatment of Attention-Deftcit/Hyperactivity Disorder (ADHD). J Am Acad Child Adolesc Psychiatry 2000; 39: 182–193.CrossRefGoogle Scholar
10.National Institute for Clinical Excellence. Guidance for the Use of Methylphenidate (Ritalin, Equasym) for Attention Deficit/Hyperactivity Disorder (ADHD) in childhood; NICE Technology Appraisal Guidance, 13. 2000 Available: www.nice.org.ukGoogle Scholar
11.Taylor, Eet al.Clinical guidelines for hyperkinetic disorder. Eur Child Adol Psychiatr 1998; 7: 184–200.CrossRefGoogle ScholarPubMed
12.American Academy of Child and Adolescent Psychiatry. Practice parameters for the use of stimulant medications in the treatment of children, adolescents, and adults. J Am Acad Child Adol Psychiatry 2002; 41 (Suppl 2): 26S–49S.CrossRefGoogle Scholar
13.Dulcan, Met al.Practice parameters for the assessment and treatment of children, adolescents, and adults with Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry 1997; 36(Suppl 10): 85S–121S.CrossRefGoogle ScholarPubMed
14. Scottish Intercollegiate Guidelines Network, 52. Attention Deficit and Hyperkinetic Disorders in Children and Young People, A National Clinical Guideline. 2001. Available: www.sign.rcpe.ac.ukGoogle Scholar
15.Kutcher, Set al.International consensus statement on attention-deficit/hyperactivity disorder (ADHD) and disruptive behaviour disorders (DBDs): Clinical implications and treatment practice suggestions. Eur Neuropsychopharmacol 2004; 14: 11–28.CrossRefGoogle ScholarPubMed
16.Burke, MS, Josephson, A, Lightsey, A. Combined methylphenidate and imipramine complication. J Am Acad Child Adol Psychiatry 1995; 34: 403–404.CrossRefGoogle ScholarPubMed
17.Grossman, LK, Grossman, NJ. Methylphenidate and Idiopathic Thrombocytopenic Purpura – Is There an Association? J Fam Pract 1985; 20: 202–204.Google ScholarPubMed
18.Satterfield, JH, Schell, AM, Barb, SD. Potential risk of prolonged administration of stimulant medication for hyperactive children. Devel Behavioural Ped 1980; 1: 102–107.Google ScholarPubMed
19.Sood, RK, Kirkwood, CK, Sood, B. MPH and thrombocytosis. J Am Acad Child Adol Psychiatry 1994; 33: 592–3.CrossRefGoogle ScholarPubMed
20.Wilens, Tet al.ADHD Treatment With Once-Daily OROS Methylphenidate: Interim 12-Month Results From a Long-Term Open-Label Study. J Am Acad Child Adol Psychiatry 2003; 42(4): 424–433.CrossRefGoogle ScholarPubMed
21.Correll, CU, Carlson, HE. Endocrine and Metabolic Adverse Effects of Psychotropic Medications in Children and Adolescents. J Am Acad Child Adol Psychiat 2006; 45: 771–791.CrossRefGoogle ScholarPubMed
22.McNicholas, F. Prescribing practices of child psychiatrists in the UK. Child Psychol Psychiatry Rev 2001; 6: 166–171.CrossRefGoogle Scholar
23.Kelly, B, Lenihan, F. Attitudes towards the implementation of the Mental Health Act 2001. Ir J Psych Med 2006; 23(2): 82–84CrossRefGoogle ScholarPubMed
24.Buckley, S, Dodd, P, Burke, A, Guerin, S, McEvoy, J, Hillery, J. Diagnosis and management of attention-deficit hyperactivity disorder in children and adults with and without learning disability. Psychiatr Bull R Coll Psychiatr 2006; 30: 251–253.CrossRefGoogle Scholar