recognizing-and-treating-catatonia-in-kleefstra-syndrome

Recognizing and Treating Catatonia in Kleefstra Syndrome

Kleefstra syndrome is a rare genetic disorder (less than 1 in 1,000,000) associated with a mutation of the euchromatic histone lysine methyltransferase 1 ...

Children's Hospital Colorado

Mental health disorders and related suicide attempts are increasing in both the adult and pediatric patient populations. Because of the increasing prevalence of mental health disorders, there is increased use of psychotropic medications in adult and pediatric patients, which can pose a risk for potentially adverse pediatric ingestions. The objective was to determine trends and outcomes for pediatric psychotropic medication ingestions reported to the American Association of Poison Control Centers (AAPCC) National Poison Data System (NPDS).

Trends of prescription psychotropic medication exposures in pediatric patients, 2009-2018.

The use of ketorolac for analgesia in the emergency department is a common practice for pediatric patients. There is a lack of guidance on optimal dosing to limit the risk of side effects especially in pediatric patients. The standard dosing is weight based with a cap at 30 mg, a dose which is higher than the typical max used for adult patients. The objective of this study is to compare the analgesic effect of intravenous ketorolac at doses of 15 mg versus doses greater than 15 mg.

Evaluation of ketorolac ceiling dose effects in pediatric patients in the emergency department.

 Current standards for treatment of anorexia nervosa (AN) in children and adolescents include Family-Based Treatment and nutrition restoration. The use of aripiprazole for AN has been detailed through case series and one retrospective review analyzing the change in outcomes on body mass index and weight restoration. The goal of this descriptive study was to evaluate the impact of aripiprazole on food avoidant behaviors (FABs) and to describe prescribing patterns, including dosing and tolerability.  This was a retrospective, descriptive, matched, cohort study of pediatric patients with AN admitted to an eating disorders program (EDP) between January 1, 2018, and December 31, 2023. Patients were included in this study if they had a diagnosis of AN and were started on aripiprazole for eating disorder cognitions. Patients were matched 1:2 to a control group based on age, sex, and length of stay.  A total of 42 patients on aripiprazole were analyzed and matched to 84 controls. Aripiprazole was associated with a reduction in FABs with a mean change over the evaluated time period of 3.5 versus 0.9 ( = 0.026). The mean starting dose of aripiprazole was 1.9 mg/day, with a mean discharge dose of 2.8 mg/day. Aripiprazole was overall well-tolerated.  Aripiprazole was associated with an improvement in FABs among children and adolescents admitted to an EDP. Additionally, low-dose aripiprazole improved weight, likelihood of achieving target weight, and was well-tolerated.

Article	Year
Trends of prescription psychotropic medication exposures in pediatric patients, 2009-2018. Clinical toxicology (Philadelphia, Pa.)\| PubMed ID: 34196239	2022
Evaluation of ketorolac ceiling dose effects in pediatric patients in the emergency department. The American journal of emergency medicine\| PubMed ID: 39729680	2025
Utility of Aripiprazole in the Treatment of Anorexia Nervosa in Children and Adolescents: A Retrospective, Descriptive, Matched Cohort Study. Journal of child and adolescent psychopharmacology\| PubMed ID: 40537086	2025

Isabelle Bindseil

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