Guest guest Posted April 2, 2004 Report Share Posted April 2, 2004 I don't know if you will have been following the concerns regarding certain antidepressant medications. Some (those that are SSRI's, like Paxil) are now banned in England for use with children because of the link to suicidal thought and action. No one knows for sure what the relationship is, whether the action of the drug triggers self-aggressive behavior, or whether the effect of relief from depression gives the youth more energy to turn against themselves. Also, we have no idea what the impact might be in someone with a condition like CHARGE. My guess is that the risk for kids with CHARGE is small, but it does mean that we need to be very careful in monitoring the effects of these and any other medications that we use with our children. Most of the psychotropic drugs were developed for and tested on adults, and there are not enough studies on their use with children. So again, make sure you are being monitored very closely by the prescribing physician. Here is a portion of an article on this from Medscape: The U.S. Food and Drug Administration (FDA) has asked manufacturers of the several antidepressant drugs to include in their labeling a warning statement that recommends close observation of adult and pediatric patients treated with their agents for worsening depression or the emergence of suicidality The antidepressant drugs are fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), escitalopram (Lexapro), buproprion (Wellbutrin), venlafaxine (Effexor), nefazodone (Serzone), and mirtazapine (Remeron). Several of these drugs are approved for the treatment of obsessive-compulsive disorder in pediatric patients (sertraline, fluoxetine, fluvoxamine). Only fluoxetine is approved for use in children with major depressive disorder. None of these drugs are approved as monotherapy in treating bipolar depression, either in adults or children, and fluvoxamine is not approved as an antidepressant in the U.S. The FDA has been closely reviewing the results of antidepressant studies in children since June 2003, after an initial report appeared to suggest increased risk of suicidal thoughts and actions in the pediatric population, according to today's advisory. Although it is unclear whether antidepressants contribute to the emergence of suicidal thinking and behavior, these interim actions are intended to draw more attention to the need for careful monitoring of patients being treated with these drugs, especially at the beginning of therapy and during dose changes. Discontinuation of medication may be appropriate in patients whose depression is persistently worse or whose emergent suicidality is severe, abrupt in onset, or was not part of the patient's presenting symptoms. Therapy changes should be made under the guidance of a physician, as certain medications should be tapered rather than stopped abruptly. Tim S. Hartshorne, Ph.D. Assistant Vice Provost and Professor of Psychology Central Michigan University Mount Pleasant, MI 48858 (989)774-3632 phone (989)774-1408 (fax) harts1ts@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 2, 2004 Report Share Posted April 2, 2004 Thanks, Tim. pam Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 2, 2004 Report Share Posted April 2, 2004 Hi , There are so many things to consider when deciding if medication is needed, if there are a variety of concerns which ones are we targeting the medication for, which medication to use, response to medication etc. I think Tim just raises another issue for us to discuss with the doctors. As with all things there are opposing views. Many parents of kids who take these medications are very upset at the thought that their kids may have to stop taking them, because in those kids it is working. On the other hand parents of kids who committed suicide want to protect others. As science grows (or medical intervention catches up with science) in this area we will learn more about why some kids do well and others don't. In the meantime we just have to work with the doctors and together try to make decisions we think is best for our child. Kim > Hmmmmmmmmmmm , interesting....we still have to go through some more tests > etc., but thinking the ocd may need to be handled with meds.......guess > we'll see what the " experts " conclude before I worry about it. > > > medications > > >> I don't know if you will have been following the concerns regarding >> certain antidepressant medications. Some (those that are SSRI's, like >> Paxil) are now banned in England for use with children because of the >> link to suicidal thought and action. No one knows for sure what the >> relationship is, whether the action of the drug triggers self-aggressive >> behavior, or whether the effect of relief from depression gives the >> youth more energy to turn against themselves. Also, we have no idea >> what the impact might be in someone with a condition like CHARGE. My >> guess is that the risk for kids with CHARGE is small, but it does mean >> that we need to be very careful in monitoring the effects of these and >> any other medications that we use with our children. Most of the >> psychotropic drugs were developed for and tested on adults, and there >> are not enough studies on their use with children. So again, make sure >> you are being monitored very closely by the prescribing physician. Here >> is a portion of an article on this from Medscape: >> The U.S. Food and Drug Administration (FDA) has asked manufacturers of >> the several antidepressant drugs to include in their labeling a warning >> statement that recommends close observation of adult and pediatric >> patients treated with their agents for worsening depression or the >> emergence of suicidality >> The antidepressant drugs are fluoxetine (Prozac), sertraline (Zoloft), >> paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), >> escitalopram (Lexapro), buproprion (Wellbutrin), venlafaxine (Effexor), >> nefazodone (Serzone), and mirtazapine (Remeron). >> Several of these drugs are approved for the treatment of >> obsessive-compulsive disorder in pediatric patients (sertraline, >> fluoxetine, fluvoxamine). Only fluoxetine is approved for use in >> children with major depressive disorder. None of these drugs are >> approved as monotherapy in treating bipolar depression, either in adults >> or children, and fluvoxamine is not approved as an antidepressant in the >> U.S. >> The FDA has been closely reviewing the results of antidepressant studies >> in children since June 2003, after an initial report appeared to suggest >> increased risk of suicidal thoughts and actions in the pediatric >> population, according to today's advisory. >> Although it is unclear whether antidepressants contribute to the >> emergence of suicidal thinking and behavior, these interim actions are >> intended to draw more attention to the need for careful monitoring of >> patients being treated with these drugs, especially at the beginning of >> therapy and during dose changes. >> Discontinuation of medication may be appropriate in patients whose >> depression is persistently worse or whose emergent suicidality is >> severe, abrupt in onset, or was not part of the patient's presenting >> symptoms. Therapy changes should be made under the guidance of a >> physician, as certain medications should be tapered rather than stopped >> abruptly. >> Tim >> S. Hartshorne, Ph.D. >> Assistant Vice Provost and Professor of Psychology >> Central Michigan University >> Mount Pleasant, MI 48858 >> (989)774-3632 phone >> (989)774-1408 (fax) >> harts1ts@... >> >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 2, 2004 Report Share Posted April 2, 2004 So....we have to watch for some of the independant young adults who run out of money to refill these types of prescriptions....that could be " disaster " ....ie. stopping without gradual withdrawl of the drug. just reading on some of the new drugs coming up (article below) difference reactions in some CHARGE kids could relate to some of the reflex drugs; hormone differences, liver enzimes...? Anyone report differences in their children's liver in CHARGE? Wouldn't a piece of the puzzle be great so they could figure out the seritonin etc...without needing those kinds of drugs! http://www.thomastthomas.com/Psychotropic%20Medications,%20Watanabe,%20012600.PD\ F > > > Hmmmmmmmmmmm , interesting....we still have to go through some more tests > > etc., but thinking the ocd may need to be handled with meds.......guess > > we'll see what the " experts " conclude before I worry about it. > > > > > > medications > > > > > >> I don't know if you will have been following the concerns regarding > >> certain antidepressant medications. Some (those that are SSRI's, like > >> Paxil) are now banned in England for use with children because of the > >> link to suicidal thought and action. No one knows for sure what the > >> relationship is, whether the action of the drug triggers self-aggressive > >> behavior, or whether the effect of relief from depression gives the > >> youth more energy to turn against themselves. Also, we have no idea > >> what the impact might be in someone with a condition like CHARGE. My > >> guess is that the risk for kids with CHARGE is small, but it does mean > >> that we need to be very careful in monitoring the effects of these and > >> any other medications that we use with our children. Most of the > >> psychotropic drugs were developed for and tested on adults, and there > >> are not enough studies on their use with children. So again, make sure > >> you are being monitored very closely by the prescribing physician. Here > >> is a portion of an article on this from Medscape: > >> The U.S. Food and Drug Administration (FDA) has asked manufacturers of > >> the several antidepressant drugs to include in their labeling a warning > >> statement that recommends close observation of adult and pediatric > >> patients treated with their agents for worsening depression or the > >> emergence of suicidality > >> The antidepressant drugs are fluoxetine (Prozac), sertraline (Zoloft), > >> paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), > >> escitalopram (Lexapro), buproprion (Wellbutrin), venlafaxine (Effexor), > >> nefazodone (Serzone), and mirtazapine (Remeron). > >> Several of these drugs are approved for the treatment of > >> obsessive-compulsive disorder in pediatric patients (sertraline, > >> fluoxetine, fluvoxamine). Only fluoxetine is approved for use in > >> children with major depressive disorder. None of these drugs are > >> approved as monotherapy in treating bipolar depression, either in adults > >> or children, and fluvoxamine is not approved as an antidepressant in the > >> U.S. > >> The FDA has been closely reviewing the results of antidepressant studies > >> in children since June 2003, after an initial report appeared to suggest > >> increased risk of suicidal thoughts and actions in the pediatric > >> population, according to today's advisory. > >> Although it is unclear whether antidepressants contribute to the > >> emergence of suicidal thinking and behavior, these interim actions are > >> intended to draw more attention to the need for careful monitoring of > >> patients being treated with these drugs, especially at the beginning of > >> therapy and during dose changes. > >> Discontinuation of medication may be appropriate in patients whose > >> depression is persistently worse or whose emergent suicidality is > >> severe, abrupt in onset, or was not part of the patient's presenting > >> symptoms. Therapy changes should be made under the guidance of a > >> physician, as certain medications should be tapered rather than stopped > >> abruptly. > >> Tim > >> S. Hartshorne, Ph.D. > >> Assistant Vice Provost and Professor of Psychology > >> Central Michigan University > >> Mount Pleasant, MI 48858 > >> (989)774-3632 phone > >> (989)774-1408 (fax) > >> harts1ts@c... > >> > >> > >> > >> Quote Link to comment Share on other sites More sharing options...
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