Document guides care of youths prescribed antipsychotic medications
CarolCohen Weitzman, M.D., FAAP
For Your Information
As pediatricians increasingly are called on to address the needs of children and adolescents
with mental health concerns, a new document can shed light on evidence-informed strategies,
including nonpharmacologic and pharmacologic interventions.
Guidance on Strategies to Promote Best Practice in Antipsychotic Prescribing for Children
and Adolescents, http://bit.ly/SAMHSArxguide, was developed by the Substance Abuse and Mental Health Services Administration (SAMHSA).
The guidance is a result of a multimodal process, including insight from a steering
committee, systematic evidence review, environmental scan and proceedings from an
expert panel meeting that included participation by AAP members. Publicly available
resources, evidence and principles that support best practice prescribing strategies
Antipsychotic medication use in children and youths in the United States is substantially
higher than in most other developed countries. Safe and effective pharmacologic therapies
are a critical issue in mental health and substance use treatment. As a site of care
coordination for complex behavioral health needs, the medical home can help families
and youths identify and decrease barriers to care.
The document describes practices for systems-level strategies to ensure safe, effective
medication use, including:
prior authorizations or mandatory peer reviews,
drug utilization reviews,
elective psychiatric consultations,
shared decision‐making tools,
quality improvement and learning collaboratives,
trauma‐informed and evidence‐based systems of care,
public reporting and quality indicators,
intensive care coordination, and
Engagement of families and youths in the process of prescribing antipsychotic medications
also is emphasized.
SAMHSA encourages pediatricians, families and youths to use the document as a resource
for information on risks and benefits associated with these medications; when developing
a plan for identifying potential side effects; and as an aid when discussing possible