Psychopharmacology and Developmental Disorders Woodfords Family ServiceKatherine Ray, MD Psychiatry ServicesDouglas Patrick, LCSW PO Box 1768 Portland,

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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!!