Category Archives: Psychotic Disorders

Psychotic Disorders in Children: Clinical Use of Antipsychotic Medications

Considerations in the Clinical Use of Antipsychotic Medications The following assertions summarize the issues discussed in this post: • Antipsychotic medications are key components in the comprehensive treatment program of severely mood dysregulated children and adolescents with psychotic symptoms, and for children and adolescents with psychotic disorders. • The second generation antipsychotics seem to offer… Read More »

Introduction To Atypical Antipsychotics

This section deals specifically with the use of atypical antipsychotics currently in use in the United States. In less than a decade, atypical antipsychotics have become the dominant force in the treatment of adult and childhood psychosis. As a result of this rapid change, the typical antipsychotics have been progressively relegated to the sidelines of… Read More »

Are Atypical Antipsychotics Better Than Conventional Antipsychotics?

Food and Drug Administration regulatory procedures assure that drugs approved for the treatment of schizophrenia have documentation of efficacy. What follows is complicated. The physician must decide which drug, at what dose, in what combination, for what period of time, for which aspect of illness, whether to use off-label and at what risk and cost.… Read More »

Indications For Antipsychotic Treatment

This section discusses some rational principles for the use of atypical antipsychotics in psychotic disorders of children and adolescents. The main tenets of this section include: • There are no FDA approved antipsychotic medication indications for use on children and adolescents. • There is limited evidence-based support for the use of antipsychotics in children and… Read More »

Use Of Atypical Antipsychotics In Aggressive Behavior

Maladaptive aggression accompanies different forms of psychopathology Affective disorders (depression, bipolar disorders), PPD, mental retardation, psychosis, PTSD, ADHD, and others can produce maladaptive aggression. The Treatment Recommendations for the use of Antipsychotics for Aggressive Youth (TRAAY) developed by the Center for the Advancement of Children’s Mental Heath and the New York State Office of Mental… Read More »

Is There An Appropriate Time To Initiate Antipsychotic Medications?

There would be limited controversy regarding the use of antipsychotic medications according to the parameters described in indications for antipsychotic medication, cited above. These indications for treatment make the use of antipsychotics mandatory. However, could the expression of a florid syndrome be aborted? Should the subthreshold syndromes receive earlier attention and intervention? Should the psychiatrist… Read More »

Recommendations For The Use And Selection Of Antipsychotics

1. Only one antipsychotic medication should be used at a time. Combinations of antipsychotics should not be tried until monotherapy with different available agents, including conventional antipsychotics, has been used for an extended period of time, for at least six weeks, at therapeutic doses (for each medication), or when single medications at therapeutic levels bring… Read More »

Clinical Use of Antipsychotic Medications: Medication Monitoring

Vinks and Walsons (2003) indications for therapeutic drug monitoring are listed in TABLE Factors to Attend to in Medication Monitoring. TABLE Factors to Attend to in Medication Monitoring Inadequate response Higher than standard dose required Serious and persistent side effects Suspected toxicity Suspected noncompliance Suspected drug-drug interactions New preparations, changing brands Emerging illnesses Presence of… Read More »

Clinical Use of Antipsychotic Medications: Compliance And Therapeutic Adherence

Frequently the concepts of therapeutic compliance and adherence are used interchangeably; there is a difference between these two concepts, though. Compliance refers to a passive acceptance of the physicians recommendations, often without recognition of the presence of a problem, or without a clear understanding of the nature of the therapeutic goals. Adherence refers to the… Read More »

Discontinuation Of Antipsychotics And Switching Of Antipsychotics

The staying power of atypical antipsychotics is poor. In the CAFE and CATIE reports three out of four patients discontinued the initial medications during 12 months and 18 months, respectively, because of lack of effectiveness or tolerability problems. Winnas (2003) asserts that the two most compelling reasons to switch antipsychotics in the treatment of adults… Read More »