Medication Storage Safety – Not a Glamorous Conversation, but Important

We all know how important the right medications can be to health, but when they are not stored properly, these same medications can become dangerous instruments of misuse.  Diversion, suicide attempts, and accidental overdose can all result from the unsecured storage of medications.  A conversation with parents about safe medications storage can sometimes be the […]

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Can Reviewing Potential Side Effects Increase their Chance of Being Reported?

It is standard (and required practice) to give informed consent prior to beginning a new medication during which possible side effects are discussed.  While few would argue with this practice, clinicians have wondered about the possibility that the very discussion of potential side effects might actually create an expectation that they will occur and thus […]

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Stimulants for Cognitive Enhancement – Social Justice or Cosmetic Psychopharmacology?

A thought provoking article in the NY times raises questions about the practice of giving stimulant medications to children who don’t meet criteria for ADHD but who nonetheless might benefit from their effects.   While the issue of stimulants being taken by competitive students trying to gain an edge in college has been well documented, this […]

Liquid Long-Acting Methylphenidate Preparation Now FDA Approved for ADHD

Beginning in January, physicians will have the new option of a liquid long-acting methylphenidate treatment that requires only once-daily dosing.  The medication, made by NextWave Pharmaceuticals (which will be sold to Pfizer), is called Quillivant XR and will be available at a 25mg/5ml (5mg/ml) concentration. The recommended starting dose for children 6 years old and […]

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Zombification Is Not an Acceptable Medication Outcome

As the Halloween season approaches, I have again been reminded of the frequent concern of parents who are considering using medication as part of the treatment plan for their child’s emotional-behavioral problems.  The dilemma that I and many other clinicians repeatedly hear from parents is that they want their child’s symptoms improved without changing the […]

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Cardiac Warnings Out for Citalopram and Escitalopram

Last year’s warnings from the FDA about dose-dependent QTc elongation and cardiac arrhythmias including Torsade De Pointes among patients taking citalopram at higher doses have been supplemented by warnings issued by HealthCanada on escitalopram (Lexapro), the S-isomer of racemic citalopram.  The FDA’s 2012 guidelines exclude escitalopram but hedge on concluding that the QT effects are […]

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Trends in Antipsychotic Medication Use 1993-2009

A new study in the Archives of General Psychiatry reports on the increasing use of antipsychotic medications in youth.  The study analyzed nearly half a million medical visits over a 17 year span (1993 through 2009).  Results showed that the number of medical visits that included an antipsychotic medication per 100 persons rose in children […]

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Drug Holidays During ADHD Treatment

With school ending and summer vacation starting, many parents of children with ADHD wonder whether or not it makes sense to do a “drug holiday” until school resumes in the Fall.  The Child Mind Institute recently provided some commentary on this issue for both parents and clinicians.  The bottom line answer, as it is for […]

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Risperidone Beats Lithium and Divalproex for Pediatric Bipolar Disorder

by John Koutras, MD A recent NIMH funded study in the May issue of the Archives of General Psychiatry found risperidone to be more efficacious than lithium or divalproex sodium for childhood mania.  The Treatment of Early Age Mania (TEAM) study comes from 5 centers across the country.  The trial was a controlled, randomized, but […]

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Questions and Answers – Clonidine

Question: So – does anyone use clonidine any more (in conjunction with stimulants for aggression or conduct problems)?  I’ve seen a number of my patients ending up on Intuniv – is that better?  Is it something I can prescribe?  I have 2-3 boys, middle school aged, on stimulants who fit the criteria I used to […]