Assignment: NRNP 6665 Prescribing for Children and Adolescents
Assignment: NRNP 6665 Prescribing for Children and Adolescents
sychotropic drugs are commonly used for children and adolescents to treat mental health disorders, yet many of these drugs are not FDA approved for use in these populations. Thus, their use is considered “off-label,” and it is often up to the best judgment of the prescribing clinician. As a PMHNP, you will need to apply the best available information and research on pharmacological treatments for children in order to safely and effectively treat child and adolescent patients. Sometimes this will come in the form of formal studies and approvals for drugs in children. Other times you may need to extrapolate from research or treatment guidelines on drugs in adults. Each individual patient case will need to be considered independently and each treatment considered from a risk assessment standpoint. What psychotherapeutic approach might be indicated as an initial treatment? What are the potential side effects of a particular drug?
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For this Assignment, you consider these questions and others as you explore FDA-approved (“on label”) pharmacological treatments, non-FDA-approved (“off-label”) pharmacological treatments, and nonpharmacological treatments for disorders in children and adolescents.
Reference:
Agency for Healthcare Research and Quality. (2015). Off-label drugs: What you need to know. https://www.ahrq.gov/patients-consumers/patient-involvement/off-label-drug-usage.htmlLinks to an external site.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
TO PREPARE
- Your Instructor will assign a specific disorder for you to research for this Assignment.
- Use the Walden library to research evidence-based treatments for your assigned disorder in children and adolescents. You will need to recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating this disorder in children and adolescents.
THE ASSIGNMENT (1–2 PAGES)
- Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents.
- Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?
- Explain whether clinical practice guidelines exist for this disorder and, if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.
- Support your reasoning with at least three scholarly resources, one each on the FDA-approved drug, the off-label, and a non-medication intervention for the disorder. Attach the PDFs of your sources.
BY DAY 7 OF WEEK 3
Submit your Assignment.
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Rubric
NRNP_6665_Week3_Assignment1_Rubric
| Criteria | Ratings | Pts | ||||
|---|---|---|---|---|---|---|
| This criterion is linked to a Learning OutcomeIn 1–2 pages, address the following: • Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents. |
|
25 pts | ||||
| This criterion is linked to a Learning Outcome• Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug? |
|
25 pts | ||||
| This criterion is linked to a Learning Outcome• Explain whether clinical practice guidelines exist for this disorder and, if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration. |
|
25 pts | ||||
| This criterion is linked to a Learning Outcome• Support your reasoning with at least three scholarly resources, one each on the FDA-approved drug, the off-label, and a non-medication intervention for the disorder. Be sure they are current (no more than 5 years old). Attach the PDFs of your sources. |
|
10 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. |
|
5 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation |
|
5 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/narrative in-text citations, and reference list. |
|
5 pts | ||||
| Total Points: 100 | ||||||
NRNP 6665 Prescribing for Children and Adolescents Sample Essay
Depression may start early in life. Frequent psychotherapy is the only choice for treating moderate depression in adolescents and children. According to Hetrick et al. (2021), in cases where depression symptoms fail to improve or worsen after a period of up to eight weeks, a prescription for an antidepressant medication may be recommended. Adolescents and teenagers experiencing moderate to profound depression typically require a combination of psychotherapy and pharmacotherapy. Combination treatment may improve a person’s coping skills, sense of self, the probability that their symptoms will go away, and connections with loved ones. The purpose of this paper is to discuss the treatment of major depressive disorders in children and adolescents.
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FDA-Approved Drug
According to Selph and McDonagh (2019), the FDA has approved the utilization of fluoxetine as the primary treatment option for younger patients diagnosed with depression. The pharmaceutical agent in question is classified as a selective serotonin reuptake inhibitor (SSRI), a medication type that carries a heightened potential for inducing suicidal ideation, necessitating vigilant supervision. When given in small doses, the medicine has shown promise in easing the symptoms of depression in youngsters after 6 to 8 weeks of treatment. Because of its improved safety, tolerability, and decreased risk of side effects, fluoxetine is supported by the clinical guidelines of both the American Psychological Association and the American Academy of Pediatrics for the treatment of pediatric depression (Araz Altay et al., 2019).
Off-Label Drug
Sertraline and other SSRIs are routinely used off-label to treat pediatric depression due to their good safety profiles. According to Potter et al. (2019), the medication has been granted approval by the FDA for the management of Obsessive-Compulsive Disorder (OCD) in children aged six years and above. Disorientation, hallucinations, and agitation have all been connected to the drug’s intoxicating quantities. However, when administered in modest doses and progressively increased by treatment results, the medication has shown notable efficacy in decreasing depressive symptoms in children when compared to other psychotropic medicines. The high effectiveness, tolerability, and safety profile of this intervention in the susceptible population has led to its widespread endorsement in various national clinical guidelines, such as those issued by the National Institute for Health and Care Excellence (NICE), for the management of pediatric depression.
Nonpharmacological Intervention
Depression in children may also be treated non-pharmacologically using techniques like cognitive behavioral therapy and other forms of psychotherapy. According to research, CBT is a powerful treatment for mild depression that may be used alone to cure the condition (Liu et al., 2021). Contrarily, when a child’s depression is severe, adopting CBT in conjunction with medication hastens the resolution of the depressive symptoms. Children can acquire resilient coping mechanisms that can improve their overall well-being. Most clinical guidelines, such as the NICE guideline, advocate for psychotherapeutic intervention as the primary treatment option for children diagnosed with depression due to the advantageous effects of cognitive behavioral therapy (CBT) implementation.
Conclusion
Despite the significant increase in the utilization of antidepressants among children and adolescents, there exists limited empirical support for the superiority of their benefits over the associated risks. Moreover, the emergence of suicidal tendencies during treatment continues to be a significant apprehension. Undoubtedly, there exists a necessity for safer and more efficacious treatments, encompassing both medical and psychological interventions, given the significant concerns surrounding overuse and prescriptions that deviate from the recommended guidelines. This discourse is anticipated to stimulate novel research and engender intellectually stimulating discourse.
References
Araz Altay, M., Bozatlı, L., Demirci Şipka, B., & Görker, I. (2019). Current Pattern of Psychiatric Comorbidity and Psychotropic Drug Prescription in Child and Adolescent Patients. Medicina, 55(5), 159. https://doi.org/10.3390/medicina55050159
Hetrick, S. E., McKenzie, J. E., Bailey, A. P., Sharma, V., Moller, C. I., Badcock, P. B., Cox, G. R., Merry, S. N., & Meader, N. (2021). New generation antidepressants for depression in children and adolescents: a network meta-analysis. Cochrane Database of Systematic Reviews, 2021(5). https://doi.org/10.1002/14651858.cd013674.pub2
Liu, W., Li, G., Wang, C., Wang, X., & Yang, L. (2021). Efficacy of Sertraline Combined with Cognitive Behavioral Therapy for Adolescent Depression: A Systematic Review and Meta-Analysis. Computational and Mathematical Methods in Medicine, 2021, 5309588. https://doi.org/10.1155/2021/5309588
Potter, L. A., Scholze, D. A., Biag, H. M. B., Schneider, A., Chen, Y., Nguyen, D. V., Rajaratnam, A., Rivera, S. M., Dwyer, P. S., Tassone, F., Al Olaby, R. R., Choudhary, N. S., Salcedo-Arellano, M. J., & Hagerman, R. J. (2019). A Randomized Controlled Trial of Sertraline in Young Children With Autism Spectrum Disorder. Frontiers in Psychiatry, 10. https://doi.org/10.3389/fpsyt.2019.00810
Selph, S. S., & McDonagh, M. S. (2019). Depression in Children and Adolescents: Evaluation and Treatment. American Family Physician, 100(10), 609–617. https://www.aafp.org/pubs/afp/issues/2019/1115/p609.html
