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Considerations in Prescribing and De-Prescribing in Pediatric Functional Neurological Disorders
Jamie Gainor DiPietro1, Alison Manning2, Heather A Chapman1
1Warren Alpert Medical School of Brown University; Hasbro Children's Partial Hospital Program; Hasbro Children's Hospital/Rhode Island Hospital; Providence, RI.
Prescribing for pediatric Functional Neurological Disorder (FND) lacks evidence. Clinicians should limit medications and focus on multidisciplinary care for children with FND to avoid overmedicalization.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
- Child and Adolescent Psychiatry
Background:
- Functional Neurological Disorder (FND) is prevalent in children and adolescents.
- FND significantly impacts quality of life and healthcare resource utilization.
- Limited evidence-based guidelines exist for pharmacotherapy in pediatric FND.
Purpose of the Study:
- To offer practical prescribing recommendations for healthcare providers treating pediatric FND.
- To synthesize current knowledge and identify gaps in the literature regarding FND pharmacotherapy in youth.
Main Methods:
- Conducted a narrative review of PubMed literature.
- Utilized keywords encompassing FND and pharmacology.
- Focused on evidence for accepted practices and literature gaps.
Main Results:
- A significant lack of evidence supports medication use in pediatric FND.
- Unique challenges complicate prescribing for this population.
- Polypharmacy and overmedicalization of functional symptoms are potential risks.
Conclusions:
- Minimize medication prescriptions for pediatric FND.
- Prioritize de-prescribing medications that may contribute to polypharmacy.
- Emphasize a comprehensive, multidisciplinary approach for pediatric FND management.
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