Pehea ka makani ʻōpio e lawe nei i nā lāʻau Antipsychotic

Ua hōʻike maikaʻi ʻia e hoʻonui ana ka nui o nā keiki e kamaʻilio ana i nā lāʻau antipsychotic. Nānā pinepine ʻia kēia ma ke ʻano he mea maikaʻi ʻole a me kahi hōʻailona o ka hoʻohana ʻana i ka lāʻau. I ka ʻoiaʻiʻo, eia nō naʻe, aia he ʻikepili liʻiliʻi e haʻi iā mākou inā e hoʻohana nui ʻia ana kēia mau lāʻau, koke a i ʻole ke hōʻike ʻia nei ka hoʻonui i ka hana kūpono a kūpono hoʻi o nā keiki me nā pilikia ʻano nui o ka naʻau. Ua hoʻomohala ʻia nā lāʻau antipsychotic e mālama i nā mākua me nā maʻi noʻonoʻo nui e like me schizophrenia a me ka maʻi bipolar. I nā makahiki i hala aku nei, ua hoʻonui ʻia kā lākou hoʻohana ʻana i nā hui ʻōpio a no nā ʻike ʻē aʻe e like me autism, ADHD, a me nā maʻi kūʻē kūʻē. Ma muli o ka lawe ʻana o kēia mau lāʻau i ka makaʻu o nā mea e like me ka momona, diabetes, a me nā neʻe ʻana o ka neʻe ʻana, ua nui ka nānā ʻana e nānā ke hoʻohana ʻia nei lākou i ke ala kūpono.

ʻO kekahi o kaʻu mau hana ka noho ʻana ma ke kōmike mokuʻāina ʻo Vermont i kapa ʻia ʻo Vermont Psychiatric Medications for Children and Adolescents Trend Monitoring Workgroup. ʻO kā mākou hana ka nānā ʻana i ka ʻikepili e pili ana i ka hoʻohana ʻana i ka lāʻau psychiatric ma waena o ka ʻōpio ʻo Vermont a hana i nā ʻōlelo i ko mākou ʻahaʻōlelo a me nā keʻena aupuni ʻē aʻe. I ka 2012, ke ʻike nei mākou i ka piʻi like o ka hoʻohana lāʻau e like me nā mea āpau, akā paʻakikī i ka ʻike ʻana i kēia ʻike huikau. Ua kānalua nā lālā o ke kōmike i nā lāʻau psychiatric i kani ai ka pūhoʻi ʻoiai ʻo nā lālā me ka hilinaʻi maikaʻi ʻana i nā lāʻau i manaʻo ʻia he mea maikaʻi paha kēia hoʻonui ʻana ʻoiai he nui nā keiki e pono ai ka lāʻau. ʻAe ʻae āpau, akā, me ka ʻole o ka ʻeli ʻana i lalo i kahi hohonu, ʻaʻole mākou e ʻike.

Ua hoʻoholo kā mākou kōmike, ʻo ka mea a mākou e makemake ai he ʻikepili i hiki maoli iā mākou ke haʻi iki aʻe e pili ana i ke kumu a me ka lawe ʻana o kēia mau keiki i kēia mau lāʻau. No laila, ua hana mākou i kahi ana pōkole i hoʻouna ʻia i ka prescriber o kēlā me kēia lāʻau antipsychotic i hāʻawi ʻia i kahi keiki Medicaid i hōʻoia ʻo Vermont ma lalo o ka makahiki 18. pono ia e ke koi ʻana i kāna hoʻopau ma mua o ka hiki ke hoʻopiha hou ʻia i nā lāʻau (nā mea e like me Risperdal, Seroquel, a me Abilify).

He hoihoi loa ka ʻikepili i loaʻa iā mākou a laila hoʻoholo mākou e pono mākou e hoʻāʻo a paʻi i nā mea i loaʻa iā mākou i kahi puke pai kaulana. ʻO kēlā ʻatikala i kākau ʻia e aʻu iho me nā poʻe loea ʻē aʻe he nui e hana ana i kēia kōmike, i puka mai i kēia lā i ka puke pai Pediatrics.

He aha ka mea i loaʻa iā mākou? Eia kekahi o nā mea nui .....

• ʻO ka hapa nui o nā lāʻau lapaʻau antipsychotic ʻaʻole ia he psychiatrists, me kahi hapa o nā kauka mālama mua e like me nā pediatricians a i ʻole nā ​​kauka ʻohana.
• ʻO ka helu o nā keiki ma lalo o 5 mau makahiki e lawe nei i kahi lāʻau antipsychotic he haʻahaʻa loa (ʻokoʻa iki paha ʻo Vermont ma aneʻi).
• ʻO ka manawa pinepine, ʻo ke kauka nāna e kuleana i kēia manawa no ka mālama ʻana i ka lāʻau antipsychotic ʻaʻole ia ka mea nāna i hoʻomaka mua. I kēlā mau hihia, ʻike pinepine ʻole ka mea kākau i kēia manawa (ma kahi o 30%) i ke ʻano o ka psychotherapy i hoʻāʻo ʻia ma mua o ka hoʻoholo e hoʻomaka i kahi lāʻau antipsychotic.
• ʻO nā diagnoses maʻamau ʻelua e pili ana i ka lāʻau lapaʻau he maʻi maʻi (ʻaʻole me ka maʻi bipolar) a me ADHD. ʻO nā ʻōkuhi pahuhopu ʻelua ʻo ka huhū o ke kino a me ka nohona ʻole o ke ʻano.
• I ka hapa nui o nā hihia, hoʻohana ʻia nā lāʻau antipsychotic ma hope wale nō o nā lāʻau lapaʻau ʻē aʻe a me nā lāʻau lapaʻau ʻona ʻole (e like me ka ʻōlelo aʻoaʻo) ʻaʻole i holo. Eia nō naʻe, ʻo ke ʻano o ka hoʻōla i hoʻāʻo pinepine ʻia ʻaʻole ia he mea e like me Behavioural Therapy, kahi hana i hōʻike ʻia he maikaʻi no nā pilikia e like me ka hoʻowahāwahā a me ka huhū.
• Ua hana maikaʻi nā kauka i ka mālama ʻana i ke kaupaona o ke keiki inā e lawe ʻo ia i kahi lāʻau antipsychotic, akā ma kahi o ka hapalua o ka manawa ke hana nei lākou i nā hana i manaʻo ʻia e nānā no nā hōʻailona hōʻailona o nā mea e like me ka maʻi kō.
• Malia paha ʻo ka mea nui loa, ua hui mākou i nā mea he nui no ke ana ʻana e hoʻāʻo a pane i ka nīnau no ka hapanui o ka manawa e hōʻeha ai ke keiki i ka lawe ʻana i kahi lāʻau antipsychotic e like me nā kuhikuhi "hoʻomaʻamaʻa maikaʻi". Ua hoʻohana mākou i nā ʻōlelo aʻoaʻo i paʻi ʻia mai ka American Academy of Child and Adolescent Psychiatry a ʻike i ke ʻano holoʻokoʻa, ukali ʻia nā kulekele hana ʻoi loa ma kahi o ka hapalua o ka manawa. I ko mākou ʻike, ʻo kēia ka manawa mua i koho ʻia ai kēia pākēneka ke pili i nā keiki a me nā antipsychotics. Ke hoʻomaʻamaʻa maikaʻi ʻole kahi kuhikuhi.
• Nānā pū mākou i ka manawa pinepine e hoʻohana ʻia ai kahi palapala kuhikuhi e like me ka hōʻike a ka FDA, kahi o nā lāpili ʻoi aku o ka hoʻohana. ʻO ka hopena - 27%.

Ke hoʻohui nei i kēia mau mea āpau, loaʻa iā mākou kahi kiʻi maopopo loa o ka mea e hana nei. I ka manawa like, ʻaʻole maʻalahi ka hopena o kēia mau hopena iā lākou iho i nā leo kani wikiwiki e pili ana i nā keiki maikaʻi ʻole, nā mākua maikaʻi ʻole, a i ʻole nā ​​kauka maikaʻi ʻole. ʻO kahi hopena i hōʻoluʻolu iki ʻaʻole ia e hōʻike ʻia me he mea lā e hoʻohana maʻamau ʻia kēia mau lāʻau no nā hana hōʻeha. ʻOiai ke ʻano o ka diagnostics iffy liʻiliʻi e like me ADHD, ua hōʻike kā mākou ʻikepili i ka pilikia maoli i hoʻokumu ʻia me kekahi mea e like me ka huhū kino. I ka manawa like, paʻakikī e haʻaheo e pili ana i ka hahai ʻana i nā ʻōlelo hoʻomaʻamaʻa ʻoi loa wale nō ka hapalua o ka manawa, keu hoʻi i ka wā a mākou e manawaleʻa ai e pili ana i ka wā e noho ana. I kā mākou kūkākūkā ʻana, nānā mākou i nā ʻehā mau mea e kōkua ai i ka hoʻomaikaʻi ʻana i ke kūlana. ʻO ka mea mua, pono i nā mea kuhikuhi i nā mea hoʻomanaʻo hou aʻe (uila a i ʻole nā ​​mea ʻē aʻe) e koi iā lākou e kiʻi i ka hana i koi ʻia e hiki ai ke hōʻike ua hiki i ka manawa e kū ai a ʻoki paha i ka lāʻau. ʻO ka lua, manaʻo nui nā kauka no ka mea ʻaʻole lākou i hoʻomaka i ka lāʻau i ka wā mua akā i kēia manawa no lākou ka kuleana a ʻaʻole ʻike pehea e kāohi ai. ʻO ke aʻo ʻana i nā kauka mālama mua e pili ana pehea a pehea e hana ai i kēia hiki ke hōʻemi i ka helu o nā keiki e lawe nei i nā lāʻau antipsychotic mau loa. ʻO ke kolu, pono mākou i kahi palapala olakino ʻoi aku ka maikaʻi e ukali kokoke i nā mea maʻi.Inā ʻoe e noʻonoʻo e pili ana i kahi keiki hānai, e kīkē ana mai kēlā me kēia wahi o ka mokuʻāina i kekahi, maʻalahi e noʻonoʻo i ka paʻakikī o kēia manawa no ke kauka o ka mahina e ʻike i ka mea i hoʻāʻo mua ʻia e kōkua i kēia keiki. ʻEhā, pono mākou e hana i nā hōʻike e pili ana i ka hōʻike hou aʻe i hiki ke pale aku i nā keiki he nui mai ka hōʻea ʻana i kahi e manaʻo ʻia ai kahi lāʻau antipsychotic.

I koʻu manaʻo, he wahi maoli nā lāʻau antipsychotic i ka lapaʻau ʻana, akā ʻo ka nui loa e hele wikiwiki nei i kēlā wahi. I kēia hāʻule i hala iho nei, ua hōʻike wau i kahi kōmike pili kānāwai Vermont hui e pili ana i kā mākou ʻike mua. E hui hou kā mākou kōmike e hoʻoholo i nā hana kikoʻī a mākou e makemake ai e ʻōlelo aʻe. ʻO ko mākou manaʻolana e hana ana nā mokuʻāina ʻē i nā papahana like e ʻike i ka hoʻohana ʻia ʻana o kēia mau lāʻau a me nā lāʻau ʻē aʻe e like me ka hiki.

@kuleana kope na David Rettew, MD

ʻO David Rettew ka mea kākau o Child Temperament: Manaʻo Hou e pili ana i ka palena ma waena o nā ʻano a me nā maʻi a me kahi psychiatrist keiki i nā keʻena psychiatry a me nā pediatrics ma ke Kulanui o Vermont College of Medicine.

E hāhai iā ia ma @PediPsych a makemake iā PediPsych ma Facebook.