Paeds Vivas · mental-behavioural-and-psychosomatic
Psychopharmacology and psychotropic medicines in children and adolescents — branching viva
Branching viva on developmental pharmacokinetics, choosing and monitoring the major paediatric psychotropic classes (stimulants, non-stimulants, SSRIs, antipsychotics, mood stabilisers, melatonin), the FDA black-box suicidality warning, antipsychotic metabolic monitoring, valproate teratogenicity, and the psychotropic emergencies (serotonin syndrome, NMS).
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Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
You are the paediatric registrar in clinic. The examiner moves from developmental pharmacokinetics to drug-class choice, dose and onset, the suicidality and metabolic monitoring obligations, valproate teratogenicity, and a psychotropic emergency.
Stem
The examiner will test whether you can reason about developmental pharmacokinetics, choose first-line psychotropics by indication with evidence, reproduce dose and onset frameworks, justify the suicidality and metabolic monitoring obligations, counsel on valproate teratogenicity, and manage a psychotropic emergency. [1] [13]
References8ShowHide
- [1]March J Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: Treatment for Adolescents with Depression Study (TADS) randomized controlled trial. JAMA, 2004.PMID 15315995
- [12]Storebø OJ Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD). Cochrane Database of Systematic Reviews, 2023.PMID 36971690
- [13]Cortese S Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. Lancet Psychiatry, 2018.PMID 30097390
- [14]Michelson D Once-daily atomoxetine treatment for children and adolescents with attention deficit hyperactivity disorder: a randomized, placebo-controlled study. American Journal of Psychiatry, 2002.PMID 12411225
- [8]Bridge JA Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis of randomized controlled trials. JAMA, 2007.PMID 17440145
- [9]Gibbons RD Suicidal thoughts and behavior with antidepressant treatment: reanalysis of the randomized placebo-controlled studies of fluoxetine and venlafaxine. Archives of General Psychiatry, 2012.PMID 22309973
- [21]Correll CU Cardiometabolic risk of second-generation antipsychotic medications during first-time use in children and adolescents. JAMA, 2009.PMID 19861668
- [22]Ray WA Association of Antipsychotic Treatment With Risk of Unexpected Death Among Children and Youths. JAMA Psychiatry, 2019.PMID 30540347