Rational use of medication for schizophrenia in children

  In China, due to the imperfect system related to the use of medication in children, almost all antipsychotic drug instructions do not write the indications for children, and it is difficult to use medication for children’s refined patients.  Our domestic drug instructions show that risperidone can be used for adolescents over 16 years of age. it is not appropriate to use any drug under 15 years of age.  The root cause of the above phenomenon is: drug manufacturers declare pediatric indications to consume a lot of money and energy, and most manufacturers are not willing to do this. Therefore, doctors can only use drugs based on their own experience and refer to international standards.  The US FDA approved risperidone and aripiprazole for children with schizophrenia, and we have used these two drugs the most in clinical applications, which are, on the whole, more effective and have fewer side effects. However, after all, these two drugs are not good enough to cure, we refer to the domestic and international literature and found that olanzapine, quetiapine fumarate and clozapine can be tried, of which clozapine can only be used for refractory schizophrenia with good efficacy, but the obesogenic effect of clozapine and olanzapine is still relatively obvious, weight gain of ten kilograms is considered less, and the increase in blood lipids is also very obvious. Other drugs, because there are few studies, still need to accumulate experience and information to evaluate their safety and effectiveness.  Generally, the younger the age, the smaller the dose of the drug, but the dose may be even larger than that of an adult in a youngster (16 or 17 years old) who is close to the adult. Because aripiprazole is metabolized very slowly in the body, it takes 3-5 days to metabolize half of the dose, so the dose should be added slowly, usually about 2 weeks before adjusting the drug dose.  Because child psychiatry is very special, it is recommended to see a child specialist. Not only is it difficult to administer medication to children, but it is also difficult to diagnose them. In addition, children’s illnesses are related to environmental factors, such as a warm and loving family can reduce morbidity, and good parenting patterns can reduce the risk of most mental illnesses, so parents must assume their role well, and no amount of money can buy a good child.