Psychopharmacology in Pediatric Critical Care

Stoddard, Frederick J.; Usher, Craigan; Abrams, Annah N.

doi:10.1016/j.chc.2006.02.005

Cited by 30 publications

(12 citation statements)

References 111 publications

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“…Medications prescribed by psychiatrists include selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, alpha-and beta-adrenergic blocking agents, anxiolytics, antipsychotics and anticonvulsants [13,14]. The rationale for treating child and adolescent patients with these drugs is derived from the fact that they are in use for adult PTSD patients, with substantial evidence for their efficacy in that age group [15].…”

Section: Psychopharmacotherapy Of Ptsd Among Children and Adolescentsmentioning

confidence: 99%

Posttraumatic Stress Disorder in Children and Adolescents: A Review of Psychopharmacological Treatment

Huemer

Erhart

Steiner

2010

Child Psychiatry Hum Dev

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The current paper aims at reviewing studies on psychopharmacological treatment of childhood and adolescent PTSD. Additionally, developmental frameworks for PTSD diagnosis and research along with an experimental model of quenching and kindling in the context of stress exposure are presented. We conducted an extensive literature search of reviews on psychopharmacotherapy as well as studies on psychopharmacological treatment for PTSD among children and adolescents. We used the database PubMed and focused on the time period of the last 10 years up to January 2009. Pertinent earlier papers were also included.There are a limited number of studies specifically assessing the psychopharmacological treatment of PTSD in children and adolescents. The vast majority of them lack verification in RCTs. Only the use of imipramine, divalproex sodium and sertraline were already evaluated in RCTs. Future studies should take into account developmental approaches to the diagnosis and treatment of PTSD in children and adolescents. In this context, different underlying neurobiological patterns, which are reflected in distinct clinical symptomatology, require a precise investigation and a symptom-orientated psychopharmacological approach.

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Section: Psychopharmacotherapy Of Ptsd Among Children and Adolescentsmentioning

confidence: 99%

Posttraumatic Stress Disorder in Children and Adolescents: A Review of Psychopharmacological Treatment

Huemer

Erhart

Steiner

2010

Child Psychiatry Hum Dev

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“…Beyond the obvious analgesic, anxiolytic, or antidepressant qualities of opiates, benzodiazepines, or antipsychotics, some of the medications in common use with burned children have direct and potent inhibitory effects on the aforementioned neurological systems. Seven potential categories of medication may inhibit the development of posttraumatic stress symptoms: opiates, 9 benzodiazepines, 10 anesthetics such as ketamine 10,11 and propofol, 12,13 antidepressants, 14,15 antipsychotics, 16 and beta-blockers. 17 By studying practice patterns, treatment of burn and overall medical care have been improved.…”

mentioning

confidence: 99%

Patterns of Medication Administration From 2001 to 2009 in the Treatment of Children With Acute Burn Injuries: A Multicenter Study

Stoddard

White

Kazis

et al. 2011

Journal of Burn Care & Research

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Children with burn injuries receive a broad range of medications, from analgesics to antipsychotics, but how utilization of these drugs differs from one pediatric burn center to another is unclear. This study examined utilization patterns of six categories of medication administered acutely to burned children as a first step in creating evidence-based practice guidelines. Six medications administered to pediatric patients enrolled in a multicenter study were recorded from patient charts using a standardized chart review template. The medication categories included opiates, benzodiazepines, antidepressants, beta-blockers, two different anesthetics, and antipsychotics. Data were analyzed by χ and logistical regression analysis. Analysis of data from three sites and 470 patients revealed significant differences in prescription patterns across hospitals for all medication groups except opiates. Differences were significant for benzodiazepines and antidepressants (χ = 7.3; P < .01 for both) controlling for age, gender, race, language, burn size, and length of stay. Differences in prescribing patterns for beta-blockers and the anesthetics ketamine and propofol failed to reach statistical significance; however, the results did trend in that direction (χ = 3.8 and 3.4, respectively; P < .10 for both). The pharmacotherapeutic agents described in this study are an integral part of acute pediatric burn care, and yet there is variation in use of these medications among the centers. The differences in prescribing indicate that, for certain drugs, a range of approaches to pharmacotherapeutics is being used and suggest that evidence-based guidelines for administration of these agents need to be developed.

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“…With this in mind, there is emerging evidence for the role of risperidone, an atypical antipsychotic, in medically compromised children and adolescents with delirium [4,11,70]. The reports of Karnik et al [71] and Scharko et al [12] raise the possibility that risperidone may be less effective in hyperactive/agitated cases of delirium among adolescent patients, while having a particular role in hypoactive cases of pediatric delirium, based on wider receptor effects and potential to selectively increase dopamine in the prefrontal area.…”

Section: Managementmentioning

confidence: 92%

“…Stoddard et al [70] have suggested a role for intravenous benzodiazepines in the management of delirium in the pediatric critical care setting. They warned, however, of the risk of sedation, paradoxical disinhibition, and worsening delirium significantly compromising the assessment and management in some cases.…”

Section: Managementmentioning

confidence: 99%

“…In both cases, good responses were obtained from a single dose of intravenous haloperidol. Stoddard et al (2006) [70] have suggested that brief use of intravenous haloperidol with later substitution of an atypical antipsychotic was increasingly becoming the case with children presenting with a delirium in the United States. If children were able to tolerate oral, nasogastric, or gastrostomy tube medications, these authors suggested that after 24 to 48 h of intravenous haloperidol, substitution of an atypical antipsychotic such as risperidone, olanzapine, or quetiapine might be appropriate.…”

Section: Managementmentioning

confidence: 99%

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