Prescribing For Children And Adolescents With Eating Disorders Essay

Prescribing For Children And Adolescents With Eating Disorders Essay

Eating disorders are psychological illnesses characterized by unusual feeding habits. Types of eating disorders include bulimia, anorexia nervosa, avoidant restrictive food eating disorder, and binge eating disorder. The management of eating disorders in children and adolescents can be pharmacological or non-pharmacological (Hay, 2020). Fluoxetine is the FDA-approved drug that is used in pharmacological management. An off-label drug that can be used is olanzapine. Additionally, cognitive behavioral therapy can be used in non-pharmacological management.

My decision for treatment will be informed by the risk score for eating disorders. Risk assessment for eating disorders can be done using the Sick, Control, One, Fat & Food (SCOFF) Questionnaire. This is a 5-item questionnaire that asks if an individual induces vomiting, loses control over the amount they eat, if they have lost more than 15 pounds in three months if they think they are fat, yet they are thin, and if food controls their life (Kutz et al., 2020). If two or more questions are answered positively, the patient is started on treatment.

According to Himmerich et al. (2021), fluoxetine is useful in managing eating disorders in that it alleviates anxiety or depression associated with the disease. The disadvantage of using fluoxetine is it can cause insomnia, dry mouth, tremors, and weakness. Olanzapine also alleviates anxiety (Copur & Copur, 2020). However, it can cause respiratory depression, hyperglycemia, and anticholinergic effects such as miosis.

The World Federation of Societies of Biological Psychiatry recommends antidepressants, antipsychotics, antiepileptics, and antihistamines to manage eating disorders. It also recommends combining pharmacological with non-pharmacological treatment. Fluoxetine is an antidepressant in the class of selective serotonin reuptake inhibitors. Olanzapine is a second-generation antipsychotic. These medications can be given along with psychotherapy.

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References

Çöpür, S., & Çöpür, M. (2020). Olanzapine in the treatment of anorexia nervosa: a systematic review. The Egyptian Journal of Neurology, Psychiatry, and Neurosurgery, 56(1), 1-7. https://doi.org/10.1186/s41983-020-00195-y

Hay, P. (2020). Current approach to eating disorders: a clinical update. Internal medicine journal, 50(1), 24-29. https://doi.org/10.1111/imj.14691

Himmerich, H., Kan, C., Au, K., & Treasure, J. (2021). Pharmacological treatment of eating disorders, comorbid mental health problems, malnutrition, and physical health consequences. Pharmacology & Therapeutics, 217, 107667. https://doi.org/10.1080/14740338.2018.1395854

Kutz, A. M., Marsh, A. G., Gunderson, C. G., Maguen, S., & Masheb, R. M. (2020). Eating disorder screening: a systematic review and meta-analysis of diagnostic test characteristics of the SCOFF. Journal Of General Internal Medicine, 35(3), 885-893. https://doi.org/10.1007/s11606-019-05478-6

Assignment 1: Prescribing for Children and Adolescents

Off-label prescribing is when a physician gives you a drug that the U.S. Food and Drug Administration (FDA) has approved to treat a condition different than your condition. This practice is legal and common. In fact, one in five prescriptions written today are for off-label use.

Psychotropic drugs are commonly used for children and adolescents to treat mental health disorders, yet many of these drugs are not FDA approved for use in these populations. Thus, their use is considered “off-label,” and it is often up to the best judgment of the prescribing clinician. As a PMHNP, you will need to apply the best available information and research on pharmacological treatments for children in order to safely and effectively treat child and adolescent patients. Sometimes this will come in the form of formal studies and approvals for drugs in children. Other times you may need to extrapolate from research or treatment guidelines on drugs in adults. Each individual patient case will need to be considered independently and each treatment considered from a risk assessment standpoint. What psychotherapeutic approach might be indicated as an initial treatment? What are the potential side effects of a particular drug?

For this Assignment, you consider these questions and others as you explore FDA-approved (“on label”) pharmacological treatments, non-FDA-approved (“off-label”) pharmacological treatments, and nonpharmacological treatments for disorders in children and adolescents.

Assigned Topic Eating Disorders

To Prepare

Your Instructor will assign a specific disorder for you to research for this Assignment.
Use the Walden library to research evidence-based treatments for your assigned disorder in children and adolescents. You will need to recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating this disorder in children and adolescents.
The Assignment (1–2 pages)

Assigned Topic Eating Disorders

Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents.
Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?
Explain whether clinical practice guidelines exist for this disorder and, if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.
Support your reasoning with at least three scholarly resources, one each on the FDA-approved drug, the off-label, and a non-medication intervention for the disorder. Attach the PDFs of your sources.

Assigned Topic Eating Disorders