Bipolar Disorder or Major Depressive Disorder

Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents.
Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?
Explain whether clinical practice guidelines exist for this disorder and, if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.

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FDA-approved drugs

  • Methylphenidate: Methylphenidate is a stimulant medication that is used to treat ADHD. It is available in a variety of forms, including tablets, capsules, and liquids. Methylphenidate is generally well-tolerated, but it can cause side effects such as insomnia, loss of appetite, and anxiety.

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Amphetamine: Amphetamine is another stimulant medication that is used to treat ADHD. It is available in a variety of forms, including tablets, capsules, and liquids. Amphetamine is generally well-tolerated, but it can cause side effects such as insomnia, loss of appetite, and anxiety.


Atomoxetine: Atomoxetine is a non-stimulant medication that is used to treat ADHD. It is available in capsule form. Atomoxetine is generally well-tolerated, but it can cause side effects such as nausea, vomiting, and decreased appetite.


Lithium: Lithium is a medication that is used to treat bipolar disorder. It is sometimes used off-label to treat ADHD. Lithium can be effective in treating ADHD, but it can also have serious side effects, such as kidney damage and tremors.


Gabapentin: Gabapentin is a medication that is used to treat seizures. It is sometimes used off-label to treat ADHD. Gabapentin can be effective in treating ADHD, but it can also have side effects such as drowsiness and dizziness.


Non-pharmacological interventions

  • Behavioral therapy: Behavioral therapy is a type of therapy that can be used to treat ADHD. Behavioral therapy can help children and adolescents learn to manage their symptoms and improve their behavior.
  • Parent training: Parent training is a type of therapy that can help parents learn how to manage their child’s ADHD symptoms. Parent training can help parents to set clear expectations, provide positive reinforcement, and use appropriate discipline techniques.
  • School-based interventions: School-based interventions can help children and adolescents with ADHD succeed in school. School-based interventions can include things like providing extra support in the classroom, modifying the curriculum, and providing counseling services.

Risk assessment

When making treatment decisions for ADHD, it is important to weigh the risks and benefits of the different treatment options. The risks of medication treatment include side effects, such as insomnia, loss of appetite, and anxiety. The risks of behavioral therapy include the time and effort required to participate in therapy. The risks of non-pharmacological interventions such as parent training and school-based interventions vary depending on the specific intervention.

Clinical practice guidelines

There are clinical practice guidelines for the treatment of ADHD in children and adolescents. These guidelines can be used to help inform treatment decisions. The guidelines recommend that medication treatment be considered as the first-line treatment for ADHD. However, the guidelines also state that behavioral therapy and non-pharmacological interventions can be effective treatments for ADHD.

Information to consider

When making treatment decisions for ADHD, it is important to consider the following information:

  • The child’s individual symptoms and severity of the disorder
  • The child’s age and developmental stage
  • The child’s medical history
  • The child’s family history of ADHD
  • The child’s response to previous treatment
  • The child’s and family’s preferences

It is also important to monitor the child’s response to treatment and adjust the treatment plan as needed.

 

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