Disruptive Mood Dysregulation Disorder Off-label Treatment Essay

THE ASSIGNMENT (1–2 PAGES)

Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents.
Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?
Explain whether clinical practice guidelines exist for this disorder and, if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.
Support your reasoning with at least three scholarly resources, one each on the FDA-approved drug, the off-label, and a non-medication intervention for the disorder. Attach the PDFs of your sources.

Disruptive Mood Dysregulation Disorder Off-label Treatment Essay

Managing Disruptive Mood Dysregulation Disorder in Pediatrics

Approved by the Food and Drug Administration, Aripiprazole is an effective therapy to minimize irritability stemming from multiple disorders, such as Autism and Disruptive Mood Dysregulation Disorder in Pediatrics. It has been shown to help in a variety of ways, including managing mood swings and less frequent outbursts that relate to the symptomology of DMDD. American Psychiatric Association (2013) notes that children with DMDD have frequent, sudden, and severe temper outbursts that are developmentally Inappropriate. The child may also demonstrate mood swings, where the child becomes easily irritated and angry, which hinders the child from managing the fundamental problems, pressure, and interpersonal relationships. Brænden et al. (2022) and Seok et al. (2023) have demonstrated a clear improvement in the various features and characteristics after administering Aripiprazole. Thus, it is possible to manage and modulate children’s irritable behavior, essential for improving their adaptation in the actual contexts. This drug could also have specific features or side effects that include obesity, changes in lipid profile, sedation, and metabolic syndromes. Thus, the physical examination of the client’s weight, blood glucose level, and lipid profile should be a routine process concerned with this medication’s safety.

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Off-label management includes the use of medications that have not been proven to be safe and optimal in managing the underlying manifestations. Risperidone is one of the significant off-label treatments for managing this disorder among children and adolescents. Although the drug may contribute to substantial effects, it is associated with various adverse effects that include weight gain, sedation, and extrapyramidal effects that require comprehensive evaluation and safety management (Laporte et al., 2021). Therefore, a comprehensive risk assessment would involve evaluating the baseline health status and metabolic effects. When implementing this treatment plan, the nurse practitioner must evaluate the medication’s effects by comparing the benefits against the risks.

Non-pharmacological Interventions

Cognitive Behavioral Therapy (CBT) is a non-pharmacological intervention that can be used in the management of DMDD. The advantages include helping children learn ways how to deal with stress, enhancing children’s emotional management, and decreasing children’s aggressive behaviors by excluding medication’s unwanted side effects (CriticalThinkRx, 2019). Benefits are low and include the possibility of low efficacy when not child-sensitive or when the parent-child relationship is poor. A risk assessment would entail understanding the child’s specific provoking factors and behaviors, the family, and guaranteeing the child the availability of a therapist who can adequately address mood dysregulation disorder.

Risk Assessment and Decision-making

Safety concerns in treating DMDD involve considering multiple aspects, including the child’s medical history and the signs and side effects associated with the suggested forms of treatment. One of the strengths of the use of aripiprazole and risperidone has been made to counterbalance some of the weaknesses, including metabolic syndrome and sedation (Seok et al., 2023). For nonpharmacological treatments, a child’s potential to interact with a therapist and family support plays a significant role. One must regularly assess the child’s progress while reassessing the treatment plan (Laporte et al., 2021). The ethical and legal foundations also highlight the need for informed consent and family participation and involvement in the decision-making process.

The Clinical Practice Guidelines

Current treatment recommendations, as evidenced by evidential documents, including the AACAP clinical practice guidelines for DMDD, support multimodal treatment that involves using pharmacological as well as non-pharmacological approaches. These guidelines endorse the use of evidence-based approved drugs such as aripiprazole and risperidone for severe instances and stress therapy like CBT (American Academy of Child and Adolescent Psychiatry, 2019). However, implementing the treatment requires an evaluation of the existing evidence, including the efficacy and safety aspects. In case of lack of a specific outline on what is appropriate for treating the diagnosis, a literature review and consultations then become the best way of making sure that the chosen course of treatment is consistent with current literature and recommendations. Furthermore, the decision-making process requires evaluating the disease and analyzing the risks against the benefits to attain the desirable outcomes.

References

American Academy of Child and Adolescent Psychiatry. (2019). Practice parameters. Aacap.org. https://www.aacap.org/AACAP/Resources_for_Primary_Care/Practice_Parameters_and_Resource_Centers/Practice_Parameters.aspx

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). CBS Publishers & Distributors, Pvt. Ltd.

Brænden, A., Zeiner, P., Coldevin, M., Stubberud, J., & Melinder, A. (2022). Underlying mechanisms of disruptive mood dysregulation disorder in children: A systematic review by means of research domain criteria. JCPP Advances, 2(1). https://doi.org/10.1002/jcv2.12060

CriticalThinkRx. (2019). Module 2: Use of Psychotropics with Youth_Prevalence and Concerns. Www.youtube.com. https://www.youtube.com/watch?v=NRef-g4Ding

Laporte, P. P., Matijasevich, A., Munhoz, T. N., Santos, I. S., Barros, A. J. D., Pine, D. S., Rohde, L. A., Leibenluft, E., & Salum, G. A. (2021). Disruptive mood dysregulation disorder: Symptomatic and syndromic thresholds and diagnostic operationalization. Journal of the American Academy of Child & Adolescent Psychiatry, 60(2), 286–295. https://doi.org/10.1016/j.jaac.2019.12.008

Seok, J.-W., Soltis-Vaughan, B., Lew, B. J., Ahmad, A., Blair, R. J. R., & Hwang, S. (2023). Psychopharmacological treatment of disruptive behavior in youths: systematic review and network meta-analysis. Scientific Reports, 13(1), 6921. https://doi.org/10.1038/s41598-023-33979-2

Disruptive Mood Dysregulation Disorder Off-label Treatment Essay

Disruptive Mood Dysregulation Disorder Off-label Treatment Essay