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

Psychopharmacology and

Developmental

Disorders

Woodfords Family Service Katherine Ray, MDPsychiatry Services Douglas Patrick, LCSWPO Box 1768Portland, ME 041041768Phone: (207) 8789663Fax: (207) 8782259

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

ConcertaMetadate CDFocalin XRRitalin LA

Methylin ERDaytranaQuillavent

Adderall XRVyvanse

Dexedrine spansule

Non - Stimulants

Antihypertensive medication:

Tenex/ Intuniv

Clonidine/ Kapvay

Antidepressants:

Wellbutrin/Wellbutrin SR/ XLStrattera

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 **ZyprexaGeodonSeroquelLatuda

“Typical” Mood stabilizers

DepakoteLithiumTegretolTrileptal

OtherLamictalNeurontinTopamax

Medications

Over the Counter Benadryl/Melatonin

Vistaril

Trazadone/ Remeron

Clonidine/Tenex

Controlled Rx

SLEEP DISORDERS

**Behavioral Approaches

Sleep HygieneBedtime RitualParent Training

Relaxation ExercisesAnxiety 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 MANAGEMENTNAMI

AACAPDHHS

ONLINE RESOURCESRESPITE

Medications….Just one part of the Big Picture!

Thank you!!