Ethics and the Prescription Pad

Psychiatry and Behavioral Sciences, Emory University School of Medicine, 492 Ponce de Leon Manor NE, Atlanta, GA 30307, USA.
Child and Adolescent Psychiatric Clinics of North America (Impact Factor: 2.6). 02/2008; 17(1):93-111, ix. DOI: 10.1016/j.chc.2007.08.003
Source: PubMed


This article reviews the considerations that inform ethical psychotropic medication prescription processes at the clinical level with child and adolescent patients and their families or guardians. Physician attributes, cultural and religious factors, and the psychodynamic aspects of psychopharmacology are reviewed, in addition to the applications of basic ethical principles and concepts to the act of dispensing psychotropic medications. Attention is given to the processes of informed consent, assent, and challenges encountered to ethical prescribing for special populations such as children in foster care and juvenile justice systems. Ramifications of black box warnings and off label prescribing are discussed. Finally, the authors offer practical tips to guide clinicians in ethical psychopharmacologic management of their child and adolescent patients.

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    • "'Off-label' use has now been recognized as a particular problem for drug safety [5,6]. The rate of 'off-label' use is especially high in pre-school children and less so in adolescents, but rates are generally high in comparison with adults [7,8]. "
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