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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:
9 7 8 - 0 - 1 2 - 8 0 0 0 1 6 - 8
eBook ISBN:
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, CanadaJI
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