Children need to pay attention to 8 major problems in the use of adolescent antidepressants

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[ China Pharmaceutical Network Health Health ] Children and adolescents with depression have increased year by year in China, which is one of the main reasons for youth suicide. Antidepressants have a good effect on the treatment of depression and anxiety in children and adolescents, but studies have shown that antidepressants may increase the risk of suicide in adolescents. The use of antidepressants in children and adolescents should be used with caution and should be used under the professional guidance of a doctor. Here, Xiao Bian summarizes the 8 major issues that need to be paid attention to during the use of antidepressants in children and adolescents.

1. Is it necessary to make a suicide warning?
The FDA reports extensive analysis of clinical trials suggest that antidepressants may cause or worsen suicidal thoughts or behaviors in a small number of children and adolescents, with a slight increase in suicidal thoughts compared to placebo. The FDA requires the drug company to issue a black box warning against the antidepressant instructions, including all SSRI drugs.
However, newer studies have shown that the benefits of antidepressants may be greater than the risk of suicide. The rate of suicide in children is reduced when taking antidepressants, and the presence of black box warnings can also reduce the number of prescriptions leading to increased suicide rates among adolescents. The result is counterproductive, so many Experts also believe that these warnings should be cancelled.
2. Why does it lead to suicidal behavior?
Because depression has a suicide risk, it is difficult to establish a clear causal relationship between antidepressant use and suicide. The researchers speculate that in addition to various underlying causes, antidepressants may also cause anxiety, agitation, hostility, restlessness, or impulsive behavior in some children, and these effects may indicate that the child's depression is getting worse and worse or even developing suicidal thoughts.
3. Should children be treated with antidepressants?
Although warnings about antidepressants and suicide risk do not mean that antidepressants should not be used in children, it should be known that such warnings are still controversial, and that more and more research tends to warn of more harm than good. The warning is not to scare people away from antidepressants, but to suggest that the advantages and disadvantages of antidepressants in children and adolescents should be carefully measured to prevent the risk of real suicide due to untreated depression.
For many children and adolescents, antidepressants are an effective way to treat depression, anxiety, obsessive-compulsive disorder, or other mental health conditions. If it is not treated effectively, it may be difficult for the child to perform normal daily life.
4. What should I do before using antidepressants?
It is important to have a thorough assessment before starting to take antidepressants. The evaluation of an experienced psychiatrist should include: 1 a detailed review of any potential risk factors that may increase the risk of self-harm; 2 assessment of possible other mental illnesses such as anxiety disorders, ADHD or bipolar disorder; 3 assessment of mentality Family history of illness or history of suicide.
5. Which antidepressant can children take?
The FDA has approved certain antidepressants for children and adolescents with different mental illnesses (table). The recommended starting and maximum doses for these drugs vary with age. It is important to know that psychiatrists may prescribe other antidepressants that are “super-instructed” depending on the actual situation.
6. What should I do if I start taking antidepressants?
The FDA recommends that doctors prescribe the minimum amount to reduce the risk of intentional or accidental medication. Clinicians, parents, and caregivers should carefully monitor changes. The high-risk time for suicide attempts and behaviors is: 1 the first few months of antidepressant treatment (first 8 weeks); 2 when increasing or decreasing the dose.
As a clinician, care should be taken to remind parents and caregivers to observe the child carefully during this period and to observe possible changes throughout the treatment. The FDA also recommends close monitoring by its health care providers during the first few months of treatment.
7. What are the signs of danger?
The signs and symptoms of suicide or self-harm are hard to see, and the child may not tell the parents directly. There are some signs that your child's symptoms may worsen, or there is a risk of suicide or self-harm: 1 talking about suicide or death, 2 trying to commit suicide or self-harm, 3 showing agitation or restlessness, 4 appearing new or worsening anxiety or panic attacks, 5 Frequent impulsive, irritable, 6 sad mood or depressive symptoms, 7 talks, energy or activity increased extremely, 8 attacks, violence or hostility, 9 sleep problems or insomnia worsened, 10 alone increased time.
If these signs appear, your child's condition may be getting worse and you need to contact your doctor immediately. Ensure that your child is treated with antidepressants without the guidance of a prescribing doctor. Sudden stop of antidepressants may lead to an unacceptable withdrawal response or worsening of the condition.
8. What other treatment options are there?
Most children's condition improves with the use of antidepressants. Drug therapy-assisted psychotherapy tends to be more effective. Among them, cognitive behavioral therapy and interpersonal relationship therapy have been shown by a large number of clinical evidence to be effective in the treatment of depression. For some children with mild symptoms, separate psychotherapy may also be effective.

Foot And Ankle Locking Plate


The foot and ankle locking plate is a special-shaped plate specially developed for calcaneal and ankle fractures, which is in line with the anatomical structure of the calcaneal and ankle joints.

During the postoperative treatment process, it can reduce the stimulation of surrounding tissues and promote bone healing.

The calcaneus is the largest of the seven tarsal bones and is located on the lower back of the foot, forming the heel. Calcaneal fractures are relatively rare, accounting for 1% to 2% of all fractures, but are important because they can lead to long-term disability. The most common mechanism of severe calcaneal fractures is axial loading of the foot after a fall from height. Calcaneal fractures can be classified into extra-articular and intra-articular fractures. Extra-articular fractures are generally easier to assess and treat. Patients with calcaneal fractures often have multiple comorbid injuries, and it is important to consider this possibility when evaluating patients.

The ankle joint is composed of the articular surface of the tibia, the lower end of the fibula, and the talar trochlea, so it is also called the talar calf joint. Ankle fractures, including fractures of the medial malleolus, lateral malleolus, posterior malleolus, or fractures of varying degrees occurring simultaneously, are due to greater violence to the medial and lateral malleolus. At the same time of both ankle fractures, the talus directly impinges posteriorly or impinges on the tibia when displaced by external rotation. Fracture of the posterior malleolus due to the posterior margin.

Foot Mini Locking Plate is composed of 2.7mm series of mini locking plate, covering a variety of plate types, widely used in trauma fixation and orthopedic surgery of the forefoot. Anatomical design of bone plate to reduce the need for shaping.


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