|An adolescent with mild intellectual disability continues to be significantly depressed despite actively participating in psychotherapy for several months. Which of the following would be the best clinical option? |
A. Start treatment with an typical antipsychotic.
B. Start treatment with an SSRI
C. Change psychotherapeutic techniques
D. Implement intensive behavioral management
The correct response is option B: Start treatment with an SSRI
Generally behavioral symptoms in individuals with intellectual disability are treated with the same medications that are used in individuals who have no intellectual disability. Children and adolescents with intellectual disability may have less of a response or have more side effects than those without cognitive issues. Starting an antidepressant as an adjunct to psychotherapy after the adolescent has failed to respond to psychotherapy alone is a appropriate approach to the treatment of adolescent depression with or without intellectual disabilities.
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Mood Disorder & Intellectual Disability
- Healthcare professionals and the US Congress have long expressed concern about online pharmacies that sell medications directly to consumers without adequate oversight by a qualified healthcare professional.
- This concern has led to proposal of the Online Pharmacy Safety Act.
- Several years ago the Act was redrafted to become an amendment to a larger bill in Congress dealing with the Food and Drug Administration
- The proposal would create a federal definition of a “valid prescription” covering all prescriptions and all pharmacies.
- The proposal required that the patient has at least one in-person medical evaluation within the previous 24 months of the prescription be written and filled.
- The proposal also required that a valid prescription either (1) meet the Controlled Substances Act definition requiring the patient to be at a hospital or clinic or (2) be issued by a defined “qualified off-site telehealth practitioner” and based on “instantaneous” communication with the patient.
- Completion of a questionnaire and/or a phone call would not be a sufficient basis for a prescription.
- All current and potential telepsychiatric practitioners should monitor this and future proposed legislation regarding prescribing in telemedicine practice.