Dr. Zev Nathan - When to refer to a Child Psychiatrist

Dr. Zev Nathan - When to refer to a Child Psychiatrist
Types of Treatment

Notes
Section 6 - Types of Treatment
Counseling - FIRST!!
Medication
--Bipolar
--Psychoses
--ADHD
--+/-OCD

Least invasive treatment
Medications Too Soon - A Pet Peeve
Under versus OVER
Using drugs that SHOULD NOT be used in children
Medication Trial
--Dosing is not certain
--Start LOW
--Go Slow - Don't Exceed the Maximums

Stimulants, Mood Stabilizers, Antidepressants
--Ritalin 60 mg
--Dexedrine 30 mg
--Adderall 30 mg

Responsibility of Referring Physician
Drugging into submission is not the point
Expect consult to include
--Teacher
--Parents
--Children
--Rating scales
--Start Low, Go Slow

Stimulants reassess quickly
Antidepressants - a month
--Prozac 2 mg Half-life 10 days!
--Paxil 1 day half life Withdrawal symptoms if misses dose

High placebo response
One in Five Follow Through With Referral

Dr. Zev Nathan - When to refer to a Child Psychiatrist Types of Treatment

Dr. Zev Nathan - When to refer to a Child Psychiatrist
Types of Treatment