University of Texas at Austin College of Pharmacy Helps Ensure Proper Use of Psychotropic Medications for Children in Foster Care

The University of Texas at Austin College of Pharmacy and the Texas Department of Family and Protective Services (DFPS) have released revised and updated parameters to ensure the proper use of psychiatric medications for children in foster care.

The "December 2010 Psychotropic Medication Utilization Parameters for Foster Children" is a resource for physicians and clinicians who care for foster children diagnosed with mental health disorders such as attention-deficit hyperactivity disorder, disruptive behavioral disorders, major depressive disorder, bipolar disorder, anxiety disorder and others.

It provides recommendations for the appropriate use of medications and includes eight criteria indicating need for further review of the child's clinical status.

"Foster children, in particular, have multiple needs, including those related to emotional or psychological stress," said Dr. Lynn Crismon, dean of the College of Pharmacy. "They typically have experienced abusive, neglectful or chaotic care-taking environments."

Crismon and Dr. James Rogers, medical director at DFPS, led a group to revise and update the guidelines. The "best practices" guide was first issued in 2005. Crismon's research has focused on psychiatric pharmacy practice and work to improve the health of adults and children with severe mental disorders.

There is a need for treatment guidelines and parameters regarding the appropriate use of psychiatric medications in foster children for several reasons, Crismon said. Patient and family history in foster children may not be readily available. In addition, there are attachment difficulties that may mimic or overlap with psychiatric disorders. Foster children may live in areas where mental health professionals such as child psychiatrists are not readily available.

"These multiple factors serve to complicate making the appropriate diagnosis and treatment," Crismon said. "The goal of the parameters is not to encourage physicians to prescribe psychotropic medications for foster children, but to encourage appropriate care of the child when they are used."

The parameters emphasize it is important to treat preschool-aged children with nonpsycho-pharmacological medications before beginning psychopharmacological treatment. They also emphasize the need to train caregivers because parent or other caregiver behavior and functioning can have a large impact on the behavior and symptoms in preschool-aged children.

For more information on the revised guidelines, visit the DFPS Web site and look for the section on Psychotropic Medication. Read the updated December 2010 Psychotropic Medication Utilization Parameters for Foster Children (PDF).