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The Science and Ethics of Antipsychotic Use in Children
1st Edition - April 24, 2015
Editors: Nina Di Pietro, Judy Illes
Hardback ISBN:9780128000168
9 7 8 - 0 - 1 2 - 8 0 0 0 1 6 - 8
eBook ISBN:9780128004814
9 7 8 - 0 - 1 2 - 8 0 0 4 8 1 - 4
The Science and Ethics of Antipsychotic Use in Children reviews the latest findings for the safety and efficacy of the rapidly rising incidence of antipsychotic use in children… Read more
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The Science and Ethics of Antipsychotic Use in Children reviews the latest findings for the safety and efficacy of the rapidly rising incidence of antipsychotic use in children and examines tensions that are created by off-label use, both in clinical psychiatric practice and research.In the past ten years, the number of antipsychotics prescribed to children with psychiatric disorders has skyrocketed. Despite this rapid growth, most medications have been inadequately studied in children for safety or efficacy and many have serious adverse health. Measures are needed to ensure that the health and safety of children are being protected, and debates have emerged over whether or not clinical trials in this population should be conducted.
Offers coverage of efficacy, prevalence, and adverse impacts of the use of antipsychotics in children
Explores ethics challenges of clinical research in this patient population
Serves as a platform for future discussions designed to increase the safety of children taking antipsychotics
Edited work with chapters authored by leading neuroethicists in the field around the globe – the broadest, most expert coverage available
Neuroethicists , clinical and research psychiatrists
Foreword
Acknowledgments
Introduction: A Call for Partnership
Chapter 1: A Brief History of the Science and Ethics of Antipsychotics and Off-Label Prescribing
Abstract
A New Era in Psychopharmacology Research Begins
A Second Generation Emerges
The Expansion of Antipsychotics: Off-Label Use in Children
Benefits in the Face of Risks
A Call for Partnership
Chapter 2: Pharmacoepidemiology of Antipsychotic Use in Canadian Children and Adolescents
Abstract
Introduction
Differences in SGA Regulation Between Canada and Other Countries
Canadian Second-Generation Antipsychotic Medications Prescription Trends for Children and Adolescents
National Prescribing Trends
Provincial Prescribing Trends
Comparing Canadian SGA Prescription Trends to those in Other Countries
Conclusions
Chapter 3: Do We Know If They Work and If They Are Safe: Second-Generation Antipsychotics for Treatment of Autism Spectrum Disorders and Disruptive Behavior Disorders in Children and Adolescents
Abstract
Introduction
Methods
Discussion
Conclusion
Chapter 4: Ensuring the Safety of Children Treated with Second-Generation Antipsychotics
Abstract
Introduction
Side Effects Associated with SGA Use in Children and Youth
Monitoring the Health of Children and Youth on SGAs
Guidelines for Metabolic Monitoring
Recommendations for Monitoring Metabolic Changes
Management of Metabolic Complications
Why Standardized Metabolic Monitoring Matters
Overcoming Barriers to Completion of Monitoring
Conclusion
Chapter 5: Pediatric Clinical Trial Activity for Antipsychotics and the Sharing of Results: A Complex Ethical Landscape
Abstract
Introduction
Mapping the Landscape: Clinical Trials for Antipsychotics in Children and Youth
Reflections on the Current State of Pediatric Clinical Trials for Antipsychotics
Recommendations
Chapter 6: Pathways to Overmedication and Polypharmacy: Case Examples from Adolescents with Fetal Alcohol Spectrum Disorders
Abstract
Introduction
Medication History in 17 Children with an FASD and Sleep Problems
Case Vignette Demonstrating Interactions between Sleep Problems, WED, and ADRs
Discussion
Conclusion and Outlook
Chapter 7: Implementing Change in Prescribing Practices
Abstract
Introduction
Pharmacotherapeutic Decision Making
The Youth and Family Experience of Psychotropic Decision Making
The Prescriber Experience of Psychotropics and Decision Making
An Approach to Designing Strategies for Changing Prescribing Behaviors
Selection of Behavior Change Techniques
Examples of Intervention Functions and Behavior Change Techniques for Improving Use of Antipsychotics
Implementation of Interventions to Change Behaviors
Future Considerations
Chapter 8: Canadian Initiatives and Recommendations: Safeguarding the Health of Children and Youth Receiving Off-Label Treatment with Antipsychotics
Abstract
Introduction
Post-Approval Monitoring of Off-Label Antipsychotic Prescriptions
Informed Consent for Patients and Caregivers
Incentivizing Clinical Trials and Expanding the Knowledge Base
Canadian Pharmaceutical Marketing Regulatory Policies
Summary of Guidelines for Prescribing Antipsychotics
Conclusion
Appendix A: List of Online Resources
Chapter 1: Introduction
Chapter 2: Pharmacoepidemiology of Antipsychotic Use in Canadian Children and Adolescents
Chapter 3: Do We Know if they Work and if they are Safe: Second-generation Antipsychotics for Treatment of Autism Spectrum Disorders and Disruptive Behavior Disorders in Children and Adolescents
Chapter 4: Ensuring the Safety of Children Treated with Second-generation Antipsychotics
Chapter 5: Pediatric Clinical Trial Activity for Antipsychotics and the Sharing of Results: A Complex Ethical Landscape
Chapter 6: Pathways to Overmedication and Polypharmacy: Case Examples from Adolescents with Fetal Alcohol Spectrum Disorders
Chapter 7: Implementing Change in Prescribing Practices
Chapter 8: Canadian Initiatives and Recommendations: Safeguarding the Health of Children and Youth Receiving Off-label Treatment with Antipsychotics
Index
No. of pages: 228
Language: English
Published: April 24, 2015
Imprint: Academic Press
Hardback ISBN: 9780128000168
eBook ISBN: 9780128004814
ND
Nina Di Pietro
Senior Research Fellow at the University of British Columbia’s “National Core for Neuroethics, Dr. Di Pietro also serves as the Neuroethics Program Lead for NeuroDevNet (Canadian org focused on children’s neurodevelopmental disorders) and is described by one reviewer as “a rising force in the field of neuroethics and developmental neuroscience.”
Affiliations and expertise
University of British Columbia, Vancouver, BC, Canada
JI
Judy Illes
Professor in the Department of Neurology and Research Chair in Neuroethics for the University of British Columbia, Dr. Illes is also Co-founder and Executive Committee Member for the Neuroethics Society. She is one of the leading voices in neuroethics today and has published extensively in this realm (Editor: Handbook of Neuroethics/2011, Neuroethics: Defining the Issues in Theory, Practice, and Policy/2005). She also serves as Chair for the International Brain Research Organization (IBRO), Committee Chair for Society for Neuroscience, Editorial Board Member for Journal of Ethics in Mental Health, and Senior Editorial Advisor for American Journal of Bioethics: Neuroscience.
Affiliations and expertise
Professor of Neurology, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada