Drug Group Definitions: Organizing Medications Based on Safety and Efficacy
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- Provides an evidenced-based framework for using psychotropic medications in youth with psychiatric diagnoses
- Designed to simplify and organize the medications into 3 manageable and targeted groups, in accordance with the American Academy of Pediatrics mental health competencies policy statement​
- Eleven safe, effective and FDA-approved medications for ADHD, anxiety and depression (Group 1) account for over 80% of psychotropic prescribing by pediatric primary care clinicians.
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- Medications for the common psychiatric disorders:
- ADHD: All FDA-approved medications for ADHD in youth
- 2 stimulants (methylphenidate and amphetamine)
- 2 α2-adrenergic agonists (guanfacine and clonidine)
- 2 norepinephrine reuptake inhibitors (atomoxetine and viloxazine)
- Major Depressive Disorder: All FDA-approved medications for depression in youth
- 2 SSRIs (fluoxetine and escitalopram)
- Anxiety Disorders:
- 3 SSRIs (fluoxetine, sertraline and fluvoxamine) with one high-quality, positive, safety and efficacy study for common anxiety disorders and FDA approval for obsessive-compulsive disorder (OCD), an anxiety-related condition
- SNRI (duloxetine) with FDA approval for generalized anxiety disorder
- ADHD: All FDA-approved medications for ADHD in youth
- These medications are relatively safe; thus, pediatric PCCs should be comfortable prescribing them and monitoring their use
- Best safety and efficacy data (with FDA approval)
- Medications for the common psychiatric disorders:
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- All FDA-approved medications for youth with other disorders (ie, not ADHD, anxiety, or depression)
- Antipsychotics (aripiprazole, asenapine, lurasidone, olanzapine, quetiapine, risperidone, and paliperidone)
- Mood-stabilizer (lithium)
- Group 2 medications have a higher risk profile and more concerning adverse effects than Group 1 medications.
- Pediatric PCCs are ideally suited to monitor adverse effects of Group 2 medications. Some pediatric PCCs, for various reasons, will be involved in prescribing them.
- All FDA-approved medications for youth with other disorders (ie, not ADHD, anxiety, or depression)
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- Medications not FDA approved for youth
- These medications have minimal or no data available regarding efficacy and safety in youth
- 10 of the more commonly used of these drugs were selected for presentation
- Bupropion (antidepressant)
- Citalopram (antidepressant; SSRI)
- Venlafaxine (antidepressant; SNRI)
- Mirtazapine (antidepressant; Tetracyclic)
- Ziprasidone (antipsychotic)
- Valproic Acid (mood stabilizer)
- Buspirone (anxiolytic)
- Lorazepam (anxiolytic)
- Trazodone (sleep aid)
- Melatonin (sleep aid)​