Behavioral Medication Information
In some locations and circumstances, child psychiatry consultations are difficult
to obtain. For some children and adolescents with ID and behavior problems, the
medical home may be the only avenue for treatment. While the following information may be helpful, it is not
exhaustive information regarding these medications. The clinician
should also refer to standard sources for additional information. [Ashworth: 2008]
Atypical Antipsychotics
Antipsychotics in general: Do baseline CMP,
fasting glucose, lipids. Check BMI. Too much can be a problem – too little can
be a problem. Watch for akathisia, dystonia (Can treat with cogentin or
benadryl). Can exacerbate diabetes.
Risperdal: Approved for “irritability syndrome” in autistic children ages 5-16 by
FDA. This might include aggression and self-injurious behavior. Avoid heroic
dosing. Start low 0.25 mg QHS or BID and increase slowly.
Qutiepine (Seroquel): Start 25 mg BID up to 800 mg daily (upper limit in adults) in
divided doses. Patients may not like anxiolytic “feel.”
Olanzapine (Zyprexa): Start 2.5 to 5 mg daily up to 30 mg (upper limit in adults)
daily. Sedation and weight gain are biggest problems.
Aripiprazole (Abilify): Start 2.5 to 5 mg daily up to 20-30 mg (upper limit in
adults). Can be activating. Doesn’t appear to affect prolactin levels.
Zipraxidone (Geodon): Start 20-40 mg BID up to 80 mg BID (upper limit in
adults). Weight neutral. Can prolong QT, so get baseline EKG.