The management of medicine is a very important component for treating symptoms of psychiatric/mental health disorders and warrants a considerable and prudent approach when treating children and adolescents. Although medications may be effective in many cases, they are only a part of the treatment plan in the sense that medicine can augment individual, adolescent group and family therapy which is equally as important! Although recent research in adolescent brain development and psychiatry has identified the neurobiochemical rationale for specific medications, these medicines work differently for each unique individual. This is why careful medication management is imperative. A conservative approach along with review of the practice parameters and guidelines outlined by the American Academy of Children and Adolescent Psychiatry and the American Psychiatric Association for children and adolescents supports any medication decisions as indicated.

“For 40 years, the AACAP Committee on Quality Issues (CQI) has been charged with the development of documents intended to inform clinical practice in child and adolescent psychiatry. Since the early Practice Parameters series, the development process for these documents has become increasingly rigorous and transparent, and for the new Clinical Practice Guideline series, the development process is consistent with recommendations of the Institute of Medicine (IOM) regarding "trustworthy guidelines", American Academy of Children and Adolescent Psychiatry, (2024) Guidelines, Updates and Parameters.

At Aerie Healthcare, the initial 1:1 intake with an adolescent participant conducted within 24-48 hours of admission provides valuable information from the participant’s perspective. In addition to review of other prior evaluations and/or discharge summaries from referring providers and facilities, a conversation with parents will further inform our treatment planning process as it pertains to medication management. We will collaborate with other psychiatric and medical providers as well. It is important to tease out any potential for undiagnosed medical conditions that may be contributing to mental health symptoms. That said, a requisition for lab tests may be recommended.

If a new medication or an adjustment in medications already prescribed is indicated, our psychiatric provider will discuss the following with the adolescent and respective parents.

• Diagnosis (es)

• Target symptoms

• Risks of the illness if untreated

• Potential benefits of the medication

• Known risks, side effects, and/or Food and Drug Administration (FDA) warnings

Whether the medication is being prescribed on-label or off-label (whether the medication has been approved for children and adolescents for the condition for which it is being prescribed).

Our psychiatric provider will meet with our Aerie participant on a weekly basis for medication management to check for effectiveness in treating symptoms and to monitor for any possible adverse effects. Parents will be communicated with on an as needed/and/or regular basis. It is important that our Aerie participant consistently takes medication as prescribed and for this reason, education about the adolescent brain and neurochemistry is provided to further enhance adherence.

Upon discharge, a psychiatric summary is created and shared with parents and our adolescent participant. This summary will also be shared with collaborating outpatient providers and referrals will be made to other providers as needed for continuity and consistency of care once our participant completes the program.

For more information please see the following:

American Academy of Child and Adolescent Psychiatry – Parameters, Updates, and Guidelines:

https://www.aacap.org/aacap/AACAP/Resources_for_Primary_Care/Practice_Parameters_and_Resource_Centers/Practice_Parameters.aspx

American Psychiatric Association - Clinical Practice Guidelines:

https://www.psychiatry.org/psychiatrists/practice/clinical-practice-guidelines

www.psychiatry.org/patients-families/medication-guides-for-parents

childmind.org/article/talking-to-kids-about-medication/