Outpatient Pharmacotherapy in a Community Mental Health Center

Storch, Daniel D.

doi:10.1097/00004583-199803000-00007

Cited by 8 publications

(6 citation statements)

References 6 publications

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“…Consistent with literature on the growing use of psychotropic medications with children, the vast majority of these psychiatrically hospitalised children had a history of psychopharmacotherapy. The prescription rate we observed was higher than most reported outpatient prescription rates (15–19%Kaplan et al, 1994; 60%Safer, 1997; 44%Storch, 1998), even though the majority of the prescriptions were made on an outpatient basis. This higher rate may reflect further increases in outpatient prescription rates since these reviews, a regional difference, and/or the symptom severity of children referred for inpatient treatment (Kaplan & Busner, 1997; Safer, 1997).…”

Section: Discussioncontrasting

confidence: 88%

“…Pharmacoepidemiological studies of outpatients suggest less frequent use of medications but also a general increase (Gadow, 1997; Kaplan et al, 1994; Safer, 1997; Storch, 1998). Notable trends over the past 20 years include increased use of selective serotonin reuptake inhibitors (SSRIs) and mood stabilisers, high (and in some studies increasing) rates of stimulant prescription, increases in polypharmacy, and decreases in tricyclic antidepressant (TCA) and conventional neuroleptic prescription (Batey & Wright, 1982; Jensen et al, 1999; Safer, 1997).…”

Section: Introductionmentioning

confidence: 99%

“…The increased use of psychotropics with children, in and of itself, is not necessarily problematic: substantial numbers of appropriate prescriptions of many kinds were noted in psychopharmacotherapy reviews in the 1990s for child outpatients and inpatients in the United States (Kaplan & Busner, 1997; Kaplan et al, 1994; Storch, 1998). In particular, the increase in SSRI use, and decreases in conventional neuroleptic and TCA use in outpatients have been described as progress given side effect and efficacy considerations (Olfson et al, 1998).…”

Section: Introductionmentioning

confidence: 99%

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Justifiable Psychopharmacology or Overzealous Prescription? Examining Parental Reports of Lifetime Prescription Histories of Psychiatrically Hospitalised Children

Zakriski

Wheeler

Burda

et al. 2005

Child Adoles Ment Health

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Background: This research investigated parent reports of pre‐admission psychotropic medication histories of psychiatrically hospitalised children in the United States. The emphasis was on identifying factors related to potentially overzealous medication use. Method: Diagnosis, insurance type, and demographics for 170 consecutive admissions were assessed via research case conference and chart review. An extreme group of children with lengthy medication histories (n = 20) was also identified, and prescription and diagnostic patterns for this group were compared to other medicated children in the sample (n = 100). Cumulative medication history, rather than specific polypharmacy, was examined. Results: Psychopharmacotherapy was common (71%). Privately insured children, children with previous psychiatric hospitalisations, and children with Oppositional Defiant Disorder (ODD), Attention Deficit Hyperactivity Disorder (ADHD), and the specific comorbidities of ODD/ADHD, and ODD/Parent Child Relational Problems had more past medication trials. Depressed children had fewer. Analyses of the extreme group suggest that young, privately insured, oppositional children with parent‐child relationship problems were at highest risk for overmedication (including multiple trials of stimulants, as well as mood stabilisers, central adrenergic agonists, and antipsychotics). Conclusions: Results raise important questions about the role of health care pressures on clinical practice in the United States.

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Section: Discussioncontrasting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Justifiable Psychopharmacology or Overzealous Prescription? Examining Parental Reports of Lifetime Prescription Histories of Psychiatrically Hospitalised Children

Zakriski

Wheeler

Burda

et al. 2005

Child Adoles Ment Health

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“…As in other conditions comorbid with BD, the use of antidepressants can worsen the clinical condition (cases 2 and 3). Antidepressants, including SSRI, have been shown to induce mania in some patients with AS [37] and also to worsen aggressive behavior. Before using SSRI in the treatment of depressive or obsessive-compulsive symptoms of AS, the comorbid presence of BD or bipolar familiarity should be excluded.…”

Section: Discussionmentioning

confidence: 99%

Comorbidity of Asperger's syndrome and Bipolar disorder

Raja

Azzoni

2008

Clin Pract Epidemiol Ment Health

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Background and objectiveAsperger's Syndrome (AS) is a pervasive developmental disorder that is sometimes unrecognized, especially in the adult psychiatric setting. On the other hand, in patients with an AS diagnosis, comorbid psychiatric disorders may be unrecognized in the juvenile setting. The aim of the paper is to show and discuss some troublesome and complex problems of the management of patients with AS and comorbid Bipolar Disorder (BD).MethodsThe paper describes three patients affected by AS and bipolar spectrum disorders.Results and conclusionMood stabilizers and 2nd generation antipsychotics were effective in the treatment of these AS patients with comorbid BD, while the use of antidepressants was associated with worsening of the mood disorder.It is of importance to recognize both the psychiatric diagnoses in order to arrange an exhaustive therapeutic program and to define specific and realistic goals of treatment.

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“…"Off-label" prescribing further demonstrates concerns for safety and efficacy in children. Studies by Geller, Reising, and Leonard (1999) and Storch (1998) reveal significant benefits to psychotropic medications used in children and adolescents for a variety of different diagnoses. However, these are limited in that they don't address the efficacy of commonly "off-labeled" prescriptions.…”

Section: Prevalencementioning

confidence: 99%