BNF for Children 2011-2012

BNFC 2011–2012 1694 Central nervous system4.1 Hypnotics and anxiolytics 1694.1.1 Hypnotics 1694.1.2 Anxiolytics 1714.1.3 Barbiturates 1714.2 Drugs used in psychoses andrelated disorders 1714.2.1 Antipsychotic drugs 1724.2.2 Antipsychotic depot injections 1814.2.3 Antimanic drugs 1814.3 Antidepressant drugs 1834.3.1 Tricyclic antidepressant drugs 1844.3.2 Monoamine-oxidase inhibitors 1864.3.3 Selective serotonin re-uptakeinhibitors 1864.3.4 Other antidepressant drugs 1884.4 CNS stimulants and other drugsfor attention deficit hyperactivitydisorder 1884.5 Drugs used in the treatment ofobesity 1914.6 Drugs used in nausea andvertigo 1924.7 Analgesics 1994.7.1 Non-opioid analgesics and compoundanalgesic preparations 1994.7.2 Opioid analgesics 2024.7.3 Neuropathic pain 2124.7.4 Antimigraine drugs 2124.7.4.1 Treatment of acute migraine 2124.7.4.2 Prophylaxis of migraine 2144.7.4.3 Cluster headache and the trigeminalautonomic cephalalgias 2144.8 Antiepileptics 2154.8.1 Control of the epilepsies 2154.8.2 Drugs used in status epilepticus 2314.8.3 Febrile convulsions 2354.9 Drugs used in dystonias andrelated disorders 2354.9.1 Dopaminergic drugs used indystonias 2354.9.2 Antimuscarinic drugs used indystonias 2374.9.3 Drugs used in essential tremor,chorea, tics, and related disorders2374.10 Drugs used in substance dependence2384.10.1 Alcohol dependence 2384.10.2 Nicotine dependence 2384.10.3 Opioid dependence 2414.11 Drugs for dementia 2414.1 Hypnotics and anxiolytics4.1.1 Hypnotics4.1.2 Anxiolytics4.1.3 BarbituratesMost anxiolytics (‘sedatives’) will induce sleep whengiven at night and most hypnotics will sedate whengiven during the day. Hypnotics and anxiolytics shouldbe reserved for short courses to alleviate acute conditionsafter causal factors have been established.The role of drug therapy in the management of anxietydisorders in children and adolescents is uncertain; drugtherapy should be initiated only by specialists afterpsychosocial interventions have failed. Benzodiazepinesand tricyclic antidepressants have been used butadverse effects may be problematic.Skilled tasks Hypnotics and anxiolytics may impairjudgement and increase reaction time, and so affectability to drive or perform skilled tasks; they increasethe effects of alcohol. Moreover the hangover effects ofa night dose may impair performance on the followingday.Important1. Benzodiazepines are indicated for the shorttermrelief (two to four weeks only) of anxietythat is severe, disabling or causing the childunacceptable distress, occurring alone or inassociation with insomnia or short-term psychosomatic,organic, or psychotic illness.2. The use of benzodiazepines to treat short-term‘mild’ anxiety is inappropriate.3. Benzodiazepines should be used to treat insomniaonly when it is severe, disabling, or causingthe child extreme distress.4.1.1 HypnoticsThe prescribing of hypnotics to children, except foroccasional use such as for sedation for procedures(section 15.1.4), is not justified. There is a risk ofhabituation with prolonged use. Problems settling childrenat night should be managed with behaviouraltherapy.4 Central nervous system