Journal of child and adolescent psychopharmacology
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J Child Adolesc Psychopharmacol · Jan 2003
Case ReportsChildhood-onset obsessive-compulsive disorder and tic disorders: case report and literature review.
A subgroup of childhood-onset obsessive-compulsive disorder (OCD) and tic disorders has been found to have a postinfectious autoimmune-mediated etiology. Clinical observations and systematic investigations have shown that a subgroup of children with OCD and/or tic disorders have the onset and subsequent exacerbations of their symptoms following infections with group A beta-hemolytic streptococci (GABHS). This subgroup has been designated by the acronym PANDAS: pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. ⋯ The proposed poststreptococcal inflammatory etiology provides a unique opportunity for treatment and prevention, including immunomodulatory therapies such as plasma exchange and intravenous immunoglobulin. A placebo-controlled trial revealed that both intravenous immunoglobulin and plasma exchange were effective in reducing neuropsychiatric symptom severity (40 and 55% reductions, respectively) for a group of severely ill children in the PANDAS subgroup. Further research is required to determine why the treatments are helpful and to ascertain whether or not antibiotic prophylaxis can help prevent poststreptococcal symptom exacerbations.
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J Child Adolesc Psychopharmacol · Jan 2001
Review Case ReportsAtypical antipsychotic overdose in the pediatric population.
Risperidone is an atypical antipsychotic medication commonly used to treat psychotic illnesses in adults. It is being used with increasing frequency in children and adolescents, even though it has yet to be approved for use in this population by the Food and Drug Administration. ⋯ We review the literature regarding risperidone overdose in all age groups and review the current literature regarding pediatric overdose with the other atypical antipsychotics currently available in the United States. From those cases it seems that special care may be warranted with all pediatric cases of atypical antipsychotic overdose, including monitoring in a high-intensity clinical setting to manage potential respiratory or cardiac difficulties.
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Advances in information technology now offer several options for child and adolescent psychopharmacologists to navigate the increasingly complex terrain of scientific literature and keep abreast of the rapidly changing advances in our field. MEDLINE, the world's largest database of medical literature, can be accessed and searched by a variety of free or fee-based services. In addition to efficient retrieval of citations and abstracts based on subject, author, or title, many of these services now provide, for a fee, the entire text and graphics of articles (displayed on computer screen, faxed, or mailed). ⋯ For online citation and abstract retrieval, we found that free services, such as PubMed, performed as good or better than fee-based services. Physicians' Online, sponsored by the pharmaceutical industry, offered the lowest price for full-text manuscript delivery. In this article, we review literature search, delivery, and update services and offer some tips on how to most effectively use these resources.
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J Child Adolesc Psychopharmacol · Jan 1992
Psychopharmacological management of migraine in children and adolescents.
ABSTRACT Migraine is one of the most common causes of pain and headache seen in the offices of pediatricians and child neurologists. In addition to standard antimigraine treatments (ergots, cyproheptadine), several types of psychotropic medication have been used in the treatment of migraine, primarily prophylactically, with varying degrees of success. Although there is some evidence of their efficacy in treating migraine in adults, there are relatively few studies of their efficacy or safety with children. ⋯ Antidepressants seem promising in adolescents and children, but more controlled studies are needed to determine their long-term efficacy in children and adolescents. Antidepressant agents with mixed serotonin and norepinephrine action (e.g., amitriptyline) seem more effective than the more selective agents in adults, but it generally remains to be seen whether antimigraine medications that are effective in adults will be equally useful in children and adolescents. Studies on mood and anxiety disorders in children and adolescents might be usefully extended to evaluate migraine headaches.