pharmacotherapy of child depresion

  1. epidemiology of depression in children
    • after puberty--risk increases 2-4 times
    • gender differences--more in women
    • incresae risk for depression among girlrs--sychosocial worry about body image, biological, physical/emotional trauma
  2. how do you recognize MDD in 3-4 year olds
    • anxiety, social withdrawal
    • language skill development decline
    • decreasd activity
    • eating or sleeping difficulties
  3. how doy ou recognize MDD in 5-12 year olds
    • sadness, low self esteem, guilt/self blame
    • pyshcial complaints--stomach aches
    • activing out behaviors--school problmes, lying, stealing, tantrums
    • accident pronesness
    • auditory hallucinations
  4. what are adolescent symptoms of mdd in adolescents
    • irritability, sadness, anxiety apthathy
    • anhdonia
    • helpless ness, sleep and appetite changes
    • socila withdrawal
    • acting out behaviors
    • substance abuse
    • delusions
    • suicidal ideations and attempts
  5. treatment approaches
    fluoxetine, citalopram, sertraline 1*
  6. how do you treat non responders
    • patient does nto respond--add CBT or switch to alternative, sertraline, italopram, escitalopram
    • patietn does nto respond to the above txm --augment lithium, bupropion mirtazapine
    • non response to augmentation
    • bupropion, mirtazapine, duloxetine, venlafacine, fule out medical comorbidities and med adherance
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pharmacotherapy of child depresion
pharmacotherapy child and adolescent MDD