Explain the circumstances under which children should be prescribed drugs for off-label use. Be specific and provide examples

2/7/22, 3:00 PM Psychopharmacologic Approaches to Treatment of Psychopathology

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BACKGROUND INFORMATION The client is an 8-year-old African American male who arrives at the ER with his mother. He is

exhibiting signs of depression.

Client complained of feeling “sad”

Mother reports that teacher said child is withdrawn from peers in class

Mother notes decreased appetite and occasional periods of irritation

Client reached all developmental landmarks at appropriate ages

Physical exam unremarkable

Laboratory studies WNL

Child referred to psychiatry for evaluation

MENTAL STATUS EXAM Alert & oriented X 3, speech clear, coherent, goal directed, spontaneous. Self-reported mood

is “sad”. Affect somewhat blunted, but child smiled appropriately at various points throughout

the clinical interview. He denies visual or auditory hallucinations. No delusional or paranoid

thought processes noted. Judgment and insight appear to be age-appropriate. He is not

endorsing active suicidal ideation, but does admit that he often thinks about himself being

dead and what it would be like to be dead.

You administer the Children's Depression Rating Scale, obtaining a score of 30 (indicating

significant depression)

RESOURCES § Poznanski, E., & Mokros, H. (1996). Child Depression Rating Scale–Revised. Los Angeles,

CA: Western Psychological Services.

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Decision Point One Select what you should do:

Begin Zoloft 25 mg orally daily

Begin Paxil 10 mg orally daily

Begin Wellbutrin 75 mg orally BID