Psychopharmacology and Developmental Disorders Woodfords Family ServiceKatherine Ray, MD Psychiatry ServicesDouglas Patrick, LCSW PO Box 1768 Portland, ME 1768 Phone: (207) 878 9663 Fax: (207) 878 2259
Approach To Medication Management * Take a Good History! -Review History from Multiple Sources *Rule Out Medical Etiology! *Include Bio/ Psycho/ Social Model -Treat Target Symptoms While Treating the Syndrome
IDENTIFYING & TREATING THE UNDERLYING SYNDROME BIO- Medications/Preventive/Regular Medical Care PSYCHO- Testing/Learning Disabilities/Skills Building/ Therapy SOCIAL – School/Work/Peers/Family
Symptom “Clusters” in Autism and Developmental Disorders “ ADHD” “ Anxiety Disorders” “ Mood Disorders” “ Sleep Disorders”
BIO / Med Management : Considerations Indication/ Approval Side effect profile Risk/Benefit profile Compliance Abuse potential
ADHD CLUSTER Hyperactivity, Impulsivity, Low frustration tolerance, Inattention, Distractibility
STIMULANTS Short/Medium Acting Methylphenidate( Ritalin) Dexmethylphenidate ( Focalin) Amphetamine ( Adderall)Dextroamphetamine ( Dexedrine) Long Acting Concerta Metadate CD Focalin XR Ritalin LA Methylin ER Daytrana Quillavent Adderall XR Vyvanse Dexedrine spansule
Non - Stimulants Antihypertensive medication: Tenex/ Intuniv Clonidine/ Kapvay Antidepressants: Wellbutrin/Wellbutrin SR/ XL Strattera Other: Provigil
ANXIETY DISORDER CLUSTER Generalized Anxiety, Social Anxiety, Obsessive Compulsive Symptoms and Behaviors
SSRI Prozac, Zoloft, Paxil, Lexapro, Celexa, Luvox SNRI Effexor XR, Cymbalta, Pristiq BUSPAR BENZO'S
MOOD DISORDERS Mood Irritability, Anger, Aggression with or without Self Injurious / Impulsive Behaviors
Atypical Antipsychotic Risperdal ** Abilify ** Zyprexa Geodon Seroquel Latuda “Typical” Mood stabilizers Depakote Lithium Tegretol Trileptal Other Lamictal Neurontin Topamax
Medications Over the Counter Benadryl/Melatonin Vistaril Trazadone/ Remeron Clonidine/Tenex Controlled Rx SLEEP DISORDERS **Behavioral Approaches Sleep Hygiene Bedtime Ritual Parent Training Relaxation Exercises Anxiety Management
PSYCHOLOGICAL TREATMENTS Psych/Neuropsychological Testing- Clarify Diagnosis/Rule Out Learning Disability Individual Therapy/ Cognitive Behavioral Therapy/Dialectical Behavioral Therapy/Skills/Coping Social Thinking/Speech Treatment Community Based Treatment/Section 28
SOCIAL TREATMENTS School/ IEP/ Behavioral Modification/Applied Behavior Analysis Peers/ Social Skills/Day program Family/Behavioral Modification/Parent Training/Home and Community Treatment Work/Vocational Rehabilitation/ Skills Building
RESOURCES CASE MANAGEMENT NAMI AACAP DHHS ONLINE RESOURCES RESPITE
Medications….Just one part of the Big Picture! Thank you!!