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Journal de Pharmacie Clinique

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Monitoring parameters for children and adolescents receiving psychotropic drugs Volume 27, issue 3, juillet, août, septembre

Authors
Département de pharmacie, AP-HP, hôpital Robert-Debré, Paris, France, Département de pharmacie clinique, Université Paris Descartes, Paris, France, Département de pharmacie et unité de recherche en pratique pharmaceutique, CHU Sainte-Justine, Montréal (Québec), Canada, Département de pharmacie, hôpital Louis-H.-Lafontaine, Montréal (Québec), Canada, Département de psychiatrie, CHU Sainte-Justine, Montréal (Québec), Canada

Objective: The objective of our study is to describe the main side effects of psychotropic medications in child and adolescent psychiatry and to propose monitoring and management strategies.Method: Review of the main side effects of psychotropic medications used in child and adolescent psychiatry, with a focus on monitoring and management strategies.Results: Although psychotropic medications can potentially cause severe cardiovascular side effects by a variety of mechanisms, cardiac arrhythmias are the most frequent cause. Before therapy with antipsychotics, stimulants or tricyclic antidepressants is initiated, a careful history, with special attention to heart disease, family history and medication use, should be obtained. ECG monitoring at baseline and during treatment has also been recommended. Children and adolescents are at risk for psychotropic medication induced weight gain, and possibly associated metabolic abnormalities (glucose resistance, diabetes type 2, dyslipidemia, metabolic syndrome). Close health monitoring and healthy lifestyle counselling are recommended to prevent these side effects. Antipsychotics require monitoring for hyperprolactinemia and lithium for thyroid function and dyscalcemia. Hematologic side effects from psychotropics may present as serious or even fatal consequences of treatment. Thus, hematologic monitoring before and during treatment is recommended.Conclusion: Clinical best practice regarding the safe and effective use of psychotropic medications for children and adolescents is based on appropriate monitoring of drug-related problems. Pharmacists can have a favourable impact on patient monitoring by providing clinical pharmacy services.