Appropriate medication – choice of medication is important
Antipsychotic drugs all have varying degrees of side effects. Children are at a critical period of physical and psychological development, and choosing the right medication plays an important role in their long-term medication and recovery.
1.What are the principles of medication for children with psychosis? Is it better to use a single medication or a combination of medications?
Choose drugs with precise efficacy, relatively small side effects, and approved for use in children. Try to use a single drug.
2. There have been three generations of antipsychotic drugs, is it true that the newer the drug, the better its efficacy?
Each of the three generations of antipsychotic drugs has its own advantages, and individualized medication is needed. It is not the case that the newer and more expensive the better. Those with fewer effective side effects are good drugs.
3, we know that non-classical antipsychotic drugs such as: clozapine, olanzapine, risperidone, etc., the reason why it works well is that it acts on dopamine (DA) and has an inhibitory effect on 5hydroxytryptamine (5HT) receptors, but now there is a theory that inhibiting 5hydroxytryptamine receptors does not have a major effect on symptoms, “DA and 5HT dual receptors ” doctrine has been discredited, is it true?
The DA receptor and 5HT receptor hypotheses for schizophrenia have not been fully proven, so the quality hypothesis built on these hypotheses needs to be treated with even more caution. The clinical observation of “DA and 5HT dual receptors” is present, so there is no denial of the “DA and 5HT dual receptors” theory.
4. In 2012, the United States ruled that the manufacturer of risperidone concealed the side effects of the drug, so what are the side effects of risperidone?
The most common ones are extrapyramidal side effects, such as increased muscle tone and inability to sit still; metabolic side effects, such as weight gain, increased prolactin causing menopause and lactation; local edema; and side effects that slow down the heart rate.
5.Is pentoxifylline a good drug with good efficacy, low price and few side effects? Can it be taken as a first-line drug for a long time?
Pentoxifylline has definite efficacy and is inexpensive. However, it is prone to extrapyramidal side effects and is not currently used as a first-line drug for long-term use.
Rational use of medication – Discontinuation and change of medication need to be cautious
There are a limited number of psychiatric medications, and each has its own advantages and disadvantages. Schizophrenia requires long-term medication, and the decision to discontinue and change medication is best made after careful discussion with the primary care physician.
6. Will my condition worsen if I use the wrong medication? Should I stop or reduce my medication immediately if it is not working?
In most cases, using the wrong medication does not worsen schizophrenia. If the efficacy is not good, it is best to observe for a period of time because antipsychotic medications have a 1-4 week onset of action. It is best to discuss this with your doctor.
7. Are symptoms such as tremors in the limbs, dull eyes, and slowed movement after taking medication side effects or an aggravation of the disease? Is it necessary to stop or change the medication if side effects occur?
This is mostly an extrapyramidal side effect caused by antipsychotic drugs, not an aggravation of the disease. If side effects occur, the medication may be reduced or given to antagonize the side effects. It is best not to discontinue or change medication.
8.What do I need to pay attention to when discontinuing and changing medication? How to make a safe transition?
The decision to discontinue or change medication should be made on an individual basis, after discussion between parents, patients and doctors. It is best to have a short period of medication discontinuation or change, and not to suddenly change or stop medication.
9. Do children with schizophrenia have to take medication for life?
There is no evidence that children with schizophrenia need to take medication for the rest of their lives, depending on the effectiveness of the treatment and individual circumstances.
10.Is there a long-acting solution for children who do not want to take medication?
There are no long-acting injections for children.
Consultation Guide ☆ 11.We know that psychiatry is special and there are not many tests available, so what is needed for the patient history information provided by the first-time patient and family?
The patient’s abnormal manifestations, such as speech, expression, and movement behavior; personal changes As well as personal growth, including gestation period, growth period, schooling, friendships, personal interests, etc. It also needs family rearing, family disease situation, etc.
12.How long does it take for the initial diagnosis to be confirmed?
In most cases, if the medical history is informative, the initial diagnosis can be made within an hour or so if the mental examination is cooperative.
13.What is the procedure for first-time patients? Can I go directly to the department?
Outpatient registration – doctor’s consultation – laboratory test – determine preliminary diagnosis – medication observation – regular follow-up
14.What information do patients need to provide for follow-up?
Information about the patient’s medication, side effects, changes in condition (symptoms), and information about the previous visit.