Services at CHIPS UnitThe Child Psychiatry In Patient unit is an 8 bed unit for diagnosis and treatment of acute and severe psychiatric illnesses or crisis in children. Bellow is a brief description of my practice in this unit:
Leaving your child in the care of the total strangers can be a scary experience. At
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· I arrive at my initial diagnosis after reviewing your child’s history, interviewing your child on the first day and staff’s observations. I reassess the initial impression during my daily rounds.
· I assist the CHIP’s team in developing an individual treatment plan for each child.
· I evaluate the need for any medication, monitoring effects and side effects.
· I will personally see your child on a daily basis.
· I am constantly in touch with the nursing staff and psychiatric social worker, who in turn are available to answer your questions and update you on the condition of your child at any time.
Please see your Parent Handbook and the Medication Handout for further information.
Psychiatric Illnesses and Treatment in Children
Parents are understandably very worried about their child’s psychiatric condition and medications. Here are some brief explanations to help you:
o Many psychiatric illnesses are caused by genetic and biochemical
factors, which can not be controlled by the child or family.
o Unfortunately, there are no tests to diagnose these “chemical” problems. Tests such as CT scans, MRIs or EEGs do not help with the diagnosis. They can only show a brain tumor, abscess or seizures, which almost never cause these illnesses.
o Children with mood disorders can have temper tantrums, irritability, anxieties and insomnia. Their hyperactivity may seem like ADHD. Some children may have both conditions. Children respond well to a variety of medications but their mood lability often comes back after a while. Medications may need to be changed or additional ones added.
o Psychiatric medications are not addicting and will not change a child’s personality. We still hold them responsible for consequences of their actions, even in clear biological illnesses.
o These medications are usually safe and their side effects, if any, are
minor. Don’t be alarmed if your child becomes sleepy or develops a muscle spasm. It is a simple reaction and will quickly go away.
o Some side effects of major mood stabilizers can be more serious with long term use. They include: weight gain, diabetes, repetitive movements (such as blinking, twitching or tongue movements), muscle spasms and irregular heartbeats. Patients should be monitored closely by their outpatient doctor.
Medications used for various conditions (This is a very brief overview and should not take the place of the detailed information provided to you and careful monitoring by your outpatient child psychiatrist)
· ADHD (“hyperactivity”):
o Ritalin, Adderall, Concerta and Metadate are stimulants which help your child to ignore distractions and focus on their studies. Side effects include decreased appetite, headaches, increase TICs, agitation and insomnia.
o Strattera is effective in some children and used when stimulants are ineffective or cause side effects. It, too, can cause agitation.
o Clonidine and Tenex at times increase effectiveness of stimulants. Side effects include decreased blood pressure and pulse. (I deleted: “rate or rapid heart beats.:)
· Agitation, anxiety or insomnia:
o Clonidine and Tenex
o Atarax/Benadryl (also allergy pills)
· Depression, panic attacks, obsessive compulsive disorders or mood swings:
o Zoloft, Paxil, Prozac, Effexor, Luvox, Lexapro and Wellbutrine are antidepressants often used to treat these conditions. Side effects include agitation, impulsivity, a “high” feeling and insomnia.
· Mood Disorders:
o Lithium Carbonate can cause nausea, diarrhea. Side effects include vomiting and diarrhea. Needs blood level monitoring, as a high level can be dangerous.
o Antiseizure drugs: Depakote, Tegretol, Trileptal, Topamax, Neurontin (all can cause sedation & some require blood tests). Lamictal has been more effective in some cases, but has a rare serious skin rash & needs to be increased very gradually.
o Major mood stabilizers: Zyprexa, Risperidone, Abilify, Geodon, Seroquel & Haldol. These are most effective, with more immediate results.
If you have any questions, please contact the CHIPS’ staff at 443-777-7077 with any questions.