Nouvelles normalités Nouvelles pathologies Nouvelles ... - Psynem

6° 6éme Congresso Congrès Européen Europeo de di Psicopatologia Psychopathologie dell’Infanzia de l’Enfance e et dell’Adolescenza
de l’Adolescence
Nuove Nouvelles normalità normalités Nuove Nouvelles patologie pathologies Nuove pratiche Nouvelles pratiques
SATURDAY, May 7 PLENARY SESSIONS
Plenary Session 6 Psychopharmacological, treatment in childhood
and adolescence: when, what, why & where
THE RATIONAL USE OF PSYCO-MEDICINE IN THE DEVELOPMENTAL AGE
Maurizio Bonati Laboratory for Mother and Child Health. Public Health Department - IRFMN, Milan (Milan - IT)
Top 10 most commonly prescribed drug combinations for
patients receiving concomitant pharmacotherapy
Concomitant pharmacotherapy 52% of children and adolescents receiving drugs
Duffy FF, et al. J Child Adolesc Psychopharmcol 2005;15:12–25
Treatment-emergent adverse events by drug
treatment in children and adolescents with ADHD
Adverse event Methylphenidate Atomoxetine Total
(No. 9; 26.5% ) (No. 42; 43.8%) (No. 51; 39.2%)
Decreased appetite 5 15 20
Thinning 1 13 14
Irritability - 9 9
Drowsiness 1 8 9
Epigastralgia - 8 8
Tachycardia - 8 8
Unstable mood - 7 7
Insomnia 1 3 4
Psychotic symptoms - 4 4
Dispepsia - 3 3
Abdominal pain - 3 3
Tic 1 2 3
Others 1 5 6
____ ____ ____
Total 10 80 90
Didoni A, et.al. EJCP in press
395
What is the evidence of toxicity?
Side-effects SSRIs are less sedating and have fewer
antimuscarinic and cardiotoxic effects than tricyclic antidepressants.
Side effects of the SSRIs include gastro-intestinal effects (doserelated
and fairly common-include nausea, vomiting, dyspepsia,
abdominal pain, diarrhoea, constipation), anorexia with weight loss
(increased appetite and weight gain also reported) and
hypersensitivity reactions including rash (consider discontinuationmay
be sing of impending serious systemic reaction, possibly
associated with vasculitis), urticaria, angioedema, anaphylaxis,
arthralgia, myalgia and photosensitivity; other side-affects include dry
mouth, nervousness, anxiety, headache, insomnia, tremor, dizzines,
asthenia, allucinations, drowsiness, conclusions, galactorrhoea,
sexual dysfunction, urinary retention, sweating, hypomania or mania,
movement disorders and dyskinesias, visual disturbances,
hyponatraemia (may be due to inappropriate antidiuretic hormone
secretion), and cutaneous bleeding disorders including ecchymoses
and purpurea. Suicidal Ideation, self harm, and hostility has been
linked with SSRIs.
Follow up of MTA study about ADHD sintoms
Years
Jensen et al. JAACAP 2007
Pharmacological intervention
in children and adolescents with autism
McPheeters ML, et al. Pediatrics 2011;e1312-21