The Use of Psychotropic Medications in Children

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The Use of Psychotropic Medications in Children Nursing professionals encounter numerous incidences that can generate ethical dilemmas if not addressed appropriately. These encounters require the use of critical thinking skills, practical decision-making, and the nurse's problem-solving capabilities. Noordsy (2016) noted that sound ethical decision-making is an important skill applicable to all healthcare events. Wise nurses identify and reflect on ethical issues surrounding their work. These professionals engage in careful habits such as consultation from experts to ensure patient care is based on evidence (Noordsy, 2016). They also involve patients and family members to ensure the treatment plan satisfies the client’s health needs and the interests of the family. Ethics play a crucial role in psychiatry by ensuring this population is provided with quality care and not discriminated against in healthcare. This paper investigates the ethical issues related to the use of psychotropic substances in pediatrics and adolescents.

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Article Summary Cicala et al (2020) describe a study investigating the safety and tolerability of antipsychotic medications in children. These participants were young people aged between 4 and 18 years. The participants were treated with risperidone, aripiprazole and olanzapine. Cicala et al. (2020) noted that antipsychotic medications have long been used in treating psychiatric disorders in pediatric populations. Unfortunately, their safety and tolerability in this population are questionable. The safety and tolerability profiles of these drugs differ from those reported among adults (Cicala et al., 2020). Treatment of psychiatric disorders requires long-term use of antipsychotic drugs. However, information concerning the safety and tolerability of these drugs on young people is derived from short-term studies. Study findings indicate that the antipsychotic medications were well tolerated by the participants (Cicala et al., 2020). However, the safety of these medications in the long-term was not established.

Ethical Issue The ethical issue highlighted by Cicala et al. (2020) is the use of antipsychotic medications on pediatric populations without clear evidence of safety and tolerability. The authors pointed out that antipsychotic medication are commonly used in pediatric populations for the treatment and management of different psychiatric conditions. The use of these medications on children and adolescents when the safety of most of them in these populations is not established increases the risk of poor health outcomes (Verdoux, 2018). Studies on the safety, dosage, and frequency of administration of antipsychotic medications are mostly done on adult populations. Therefore, the use of such dosages on children is not safe. Shahidullah, Hostutler, and Forman (2019) noted that the generalization of the safety of antipsychotic medications on young people based on adult-based studies is inappropriate.

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Texas Law and Regulations Texas has developed a set of rules and regulations to guide the use of psychotropic substances in pediatrics and adolescents. The regulations encourage safe prescribing practices in these populations. Texas Children Commission (2020) noted that since psychotropic substances affect the mind and alter mental processes, nurses should be cautious when administering them to young people. The nurse should rely on the DSM-V for the diagnosis of pediatric mental health disorders. Texas law supports the temporary use of these substances to relieve emotional stress and improve function at home, school, and the community. The law also requires informed consent for pediatric psychopharmacology. The clinicians must obtain informed consent from a legally recognized person before administering psychotropic medications to children (Texas Children Commission, 2020). The nurse must also provide the parent or the guardian with alternative treatment methods to enhance decision-making. Texas regulations encourage psychotherapeutic intervention to pharmacological interventions in pediatric cases (Texas Children Commission, 2020).

Ethical Decision-Making Process Ethical-decision making is a five-phase process that begins with the identification of a potential ethical dilemma. This phase is followed by the collection of relevant information regarding the health issue at hand. This information helps to identify potential contributors to an ethical dilemma. The third phase involves the identification of alternative solutions. The nurse then compares these alternatives to determine the most effective ones (Pope & Vasquez, 2016).

The safety of these alternatives is also determined at this stage.

The ethical issue in this paper is the use of psychotropic medications in young people.

The nurse can resolve this issue by adhering to the established rules and regulations. The first

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step is to assess the patient’s mental health per the DSM-V guidelines to determine the present psychological disorder. The next step is to gather data regarding the clients’ health and other similar cases that were resolved adequately. The nurse then identifies potential treatment options for the client. These treatments are then compared with psychopharmacological interventions to determine the safest and the most effective option (Pope & Vasquez, 2016). The nurse then selects and integrates the safest option into the treatment Splan.

Conclusion Treatment of children with antipsychotic medications generates ethical controversies.

These medications can cause addiction if not correctly used. Nurse practitioners should apply critical thinking skills to determine if a child should be prescribed antipsychotic drugs.

Consultation with other providers is essential when dealing with pediatrics to maximize the benefits of the services provided to this population.

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References Cicala, G., Barbieri, M. A., Santoro, V., Tata, C., Colucci, P. V., Vanadia, F., Drago, F., Russo, C., Cutroneo, P. M., Gagliano, A., Spina, E., & Germanò, E. (2020). Safety and Tolerability of Antipsychotic Drugs in Pediatric Patients: Data From a 1-Year Naturalistic Study. Frontiers in psychiatry, 11(152), 1-9. https://doi.org/10.3389/fpsyt.2020.00152 Noordsy D. L. (2016). Ethical Issues in the Care of People with Schizophrenia. Focus (American Psychiatric Publishing), 14(3), 349–353. https://doi.org/10.1176/appi.focus.20160011 Shahidullah, J. D., Hostutler, C. A., & Forman, S. G. (2019). Ethical considerations in medication-related roles for pediatric primary care psychologists. Clinical Practice in Pediatric Psychology, 7(4), 405–416. https://doi.org/10.1037/cpp0000285 Texas Children Commission. (2020). Psychotropic Medication. http://benchbook.texaschildrenscommission.gov/pdf/Bench%20Book %202017%20Psychotropic%20Medication.pdf Verdoux, H. (2018). Safety of psychotropic medicines: contribution from observational evidence. Epidemiology and psychiatric sciences, 27(6), 531-536. http://doi:10.1017/S2045796018000276 Pope, K. S., & Vasquez, M. J. (2016). Ethics in psychotherapy and counseling: A practical guide. John Wiley & Sons.