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Effectiveness of Psychotropic Medications in Children with Prenatal Alcohol and Drug Exposures: A Case Series and Model of Care

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Abstract

Fetal Alcohol Spectrum Disorders affect up to 5% of the population, with additional children affected by prenatal drug exposures. The majority of these children display symptoms of ADHD and poor emotional dysregulation, a common reason for seeking psychiatric care. However, high prevalence of comorbid look-alike symptoms and limited availability of evidence-based treatments complicates psychiatric decision making in this population. The goal of the current study is to report on the effectiveness of psychotropic medications in a case series of 16 individuals with prenatal alcohol/drug exposure and propose a model for psychiatric care for this population. In addition to traditional subjective reports, an objective continuous performance test (T.O.V.A.®) was used to aid with guiding treatment. We found that T.O.V.A.®-scores improved on average from − 6.5 to − 2.9 with our psychiatric approach (p = 0.03). T.O.V.A.®-measurements were helpful in differentiating ADHD symptoms from comorbid symptoms and to guide decision-making on starting and changing medications.

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Funding

Funding for this study was provided by a grant from the Department of Behavioral Health and Developmental Disabilities, State of Georgia, Contract # 44100-907-0000056259, NIH/NIAAA Diversity Supplement 3U01AA026108-04S1A and the American Academy of Child and Adolescent Psychiatry (AACAP) Pilot Research Award for Junior Faculty and Child and Adolescent Psychiatry Fellows, supported by AACAP.

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Authors and Affiliations

  1. Barrow Neurological Institute at Phoenix Children’s Hospital, 1919 E Thomas Rd, Phoenix, AZ, 85016, USA

    Gaby J. Ritfeld

  2. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA

    Gaby J. Ritfeld, Julie A. Kable, Jennifer E. Holton & Claire D. Coles

  3. Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA

    Julie A. Kable & Claire D. Coles

Authors
  1. Gaby J. Ritfeld
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  2. Julie A. Kable
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  4. Claire D. Coles
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Correspondence to Gaby J. Ritfeld.

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Ritfeld, G.J., Kable, J.A., Holton, J.E. et al. Effectiveness of Psychotropic Medications in Children with Prenatal Alcohol and Drug Exposures: A Case Series and Model of Care. Child Psychiatry Hum Dev (2022). https://doi.org/10.1007/s10578-022-01451-3

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