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Review
. 2022 Nov 30;9(12):1878.
doi: 10.3390/children9121878.

The Use of Psychotropic Medication in Pediatric Oncology for Acute Psychological and Psychiatric Problems: Balancing Risks and Benefits

Johanna M C Blom  1   2 , Elena Barisone  3 , Marina Bertolotti  3 , Daniela Caprino  4 , Monica Cellini  5 , Carlo Alfredo Clerici  6   7 , Chiara Colliva  8 , Cinzia Favara-Scacco  9 , Silvia Di Giuseppe  10 , Momcilo Jankovic  11 , Alessia Pancaldi  5 , Luca Pani  1   2   12 , Geraldina Poggi  13 , Veronica Rivi  14 , Fabio Tascedda  2   14 , Riccardo Torta  15 , Dorella Scarponi  16
Affiliations
Review

The Use of Psychotropic Medication in Pediatric Oncology for Acute Psychological and Psychiatric Problems: Balancing Risks and Benefits

Johanna M C Blom et al. Children (Basel). .

Abstract

Severe acute behavioral and emotional problems represent one of the most serious treatment-related adverse effects for children and adolescents who have cancer. The critical and severe nature of these symptoms often makes necessary the use of psychotropic drugs. A working group composed of experts in multiple disciplines had the task of creating an agreement regarding a management plan for severe acute behavioral and emotional problems (SABEPs) in children and adolescents treated for cancer. To obtain global information on the use of psychotropic drugs in pediatric oncology, the working group first developed and mailed a 15-item questionnaire to many Italian pediatric oncology centers. Overall, an evident lack of knowledge and education regarding the use of psychotropic medications for the treatment of SABEPs was found. Thus, by referring to an adapted version of the Delphi method of consensus and standard methods for the elaboration of clinical questions (PICOs), the working group elaborated evidence-based recommendations for psychotropic drugs in the pediatric oncology setting. Furthermore, based on a thorough multivariate analysis of needs and difficulties, a comprehensive management flow was developed to optimize therapeutic interventions, which allows more accurate and efficient matching of the acute needs of patients while guiding treatment options.

Keywords: antidepressant; mental health; pediatric oncology; psychotropic drugs.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Clinical Presentation. * Note: the use of psychotropic drugs in children is almost exclusively off-label (see Table 1, Table 2 and Table 3 for dose/age).
Figure A2
Figure A2
Psychotic Symptoms and Delirium in Pediatric Oncology.* Note: the use of psychotropic drugs in children is almost exclusively off-label (see Table 1 for dose/age).
Figure A3
Figure A3
Depressive Symptoms or Mood Disorders in Pediatric Oncology. * Note: the use of anxiolytic drugs in children is almost exclusively off-label (see Table 2 for dose/age).
Figure A4
Figure A4
Anxiety-Related Symptoms in Pediatric Oncology. * Note: the use of anxiolytic drugs in children is almost exclusively off-label (see Table 2 and Table 3 for dose/age).
Figure A5
Figure A5
Definition of the Psychopathological Risk of Children and Adolescents in Pediatric Oncology and the Choice of Psychotropic Drugs.
Figure 1
Figure 1
Recommendations are in green and critical issues are in red.
See this image and copyright information in PMC

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