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!!