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Is it safe to prescribing a 6 year old boy Abilify 5mg?
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sandie_j_alice posted:
I have a friend with a 6 year old boy that was taken to a psychiatrist because of self regulation issues at school. Which to have self regulation you must have a self concept (which 6 year olds do not have a complete grasp on.) The child was not diagnosed with bipolar, schizophrenia, depression, or anything for that matter. The psychiatrist wrote him a prescription for Abilify 5 mg a day for his aggressive behavior at school. Is this a mistake? The intial dosage for Abilify is 2mg for adolescent patients (10-17 years of age). Abilify is also for people with depression who are on antidepressants already. This child is not on any type of medication for anything until this psychiatrist prescribed him Abilify 5mg. Is is justifiable to prescribe a 6 year old boy Abilify 5mg without properly diagnosing the child?

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Is it appropriate to prescribe a 6 year old boy Abilify 5mg a day?
  • Yes, Very appropriate dosage and medication
  • No. This should not be prescribed.
  • I honestly do not know if this is appropriate for a 6 year old.
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hope7951 responded:
I'm not a doctor, have never been a mother, my only qualification is vaguely remembering being 5. I would no allow a psychiast to give a 5 year old an anti-psychotic. If the kid is acting out it is either physical or environmental. I'd spend a lot of time asking the kid what he feels is going on before put on any meds. Joye
 
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sandie_j_alice replied to hope7951's response:
Thanks Joye. I've suggested to my friend to look deeper into the underlying issues and to ask other doctors for an opinion. Now, only time will tell. Sandie
 
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Joseph F Goldberg, MD responded:
Sandie,
It can be hard to make a clear diagnosis in a 5 year-old, and there are no real studies to guide any type of "standard" psychiatric medication treatment for kids under 10. Doctors sometimes do treat symptoms instead of diagnoses if they think the symptoms might respond to a medicine (e.g., impulsive aggression, agitation) when there is no obvious diagnosis fits as a pigeon hole. The DSM-V is contemplating a new category to be called "Temper Dysregulation with Dysphoria" as a more descriptive and accurate way to identify explosive anger outbursts that are not more compellingly explained by a diagnosis like bipolar disorder or schizophrenia or a conduct disorder. In the ideal, a doctor would explain their decision to treat symptoms rather than a diagnosis as well as to explain that there are no standard medications for kids under 10 and therefore the alternative would be a non-medication treatment approach alone. It is a decision process the parents and doctor should go through together. - Dr. G.
 
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sandie_j_alice replied to Joseph F Goldberg, MD's response:
Thank-you very much Doctor Joseph Goldberg. I appreciate the quick response! Have a good one! -Sandie
 
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KathiKnick replied to Joseph F Goldberg, MD's response:
Dr Goldberg - as a teacher of low functioning autistic children I only touch the tip of the iceberg understanding medications. However I appreciate your input on the use of abilify as my great nephew has been on it for over a year and he is now 7 going on 8. Yes in an ideal world accurate ways of identifing the cause for the explosive anger outbursts and treat it instead of medicating the syptom, in my opinion should be the corse of action. As we know that takes time and effort on all those directly involved and some of those who are not. Seems that most involved want a quick fix and have it go away. As of this coming September we are on school number three in 15 months and no closer to understanding the child and any underlying causes which are many.
Again thanks for you respose to Sandie and maybe someday there will be a greater bonding amoung people in this field and medical coverage to go this route of diagnosis and treatment.
- Kathi
 
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Joseph F Goldberg, MD replied to KathiKnick's response:
Dear Kathi, Since the time this thread was originally posted 4 years ago, Abilify has received an additional indication and FDA approval for treatment of autism in children as young as 6 years old, so there is now a greater body of research evidence for both the safety and efficacy of its use in 6 year-olds. Dr. G.
 
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michellelewis replied to Joseph F Goldberg, MD's response:
have a friend whose son is 5 and has been diagnosed with bipolar disorder. He has recently been put on abilify and he's seeing things not there Is this normal and how safe is abilify for a child of this age?
 
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Joseph F Goldberg, MD replied to michellelewis's response:
Dear Michelle,
The short answer is that no medicines for mood have been studied for children under age 10, and diagnosing bipolar disorder before age 10 is very controversial. For something so very rare as possible bipolar disorder (or any psychiatric problem, versus a medical-neurological-developmental problem), you would ideally want to see a child psychiatrist with extensive expertise in working with children of this age, since there isn't much research to guide treatment decisions but you're relying on the expertise of the practitioner in making as accurate a diagnosis as possible and not missing something else that's more common than bipolar disorder -- as well as doing the proper medical/neurologic evaluation.
Dr. G.


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