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PRESCRIBING FOR CHILDREN AND ADOLESCENTS Off-label prescribing is when a physician gives you a drug that the U.S. Food and Drug Administration

June 2, 2025

PRESCRIBING FOR CHILDREN AND ADOLESCENTS

Off-label prescribing is when a physician gives you a drug that the U.S. Food and Drug Administration (FDA) has approved to treat a condition different than your condition. This practice is legal and common. In fact, one in five prescriptions written today are for off-label use.

—Agency for Healthcare Research and Quality

Psychotropic drugs are commonly used for children and adolescents to treat mental health disorders, yet many of these drugs are not FDA approved for use in these populations. Thus, their use is considered “off-label,” and it is often up to the best judgment of the prescribing clinician. As a PMHNP, you will need to apply the best available information and research on pharmacological treatments for children in order to safely and effectively treat child and adolescent patients. Sometimes this will come in the form of formal studies and approvals for drugs in children. Other times you may need to extrapolate from research or treatment guidelines on drugs in adults. Each individual patient case will need to be considered independently and each treatment considered from a risk assessment standpoint. What psychotherapeutic approach might be indicated as an initial treatment? What are the potential side effects of a particular drug?

For this Assignment, you consider these questions and others as you explore FDA-approved (“on label”) pharmacological treatments, non-FDA-approved (“off-label”) pharmacological treatments, and nonpharmacological treatments for disorders in children and adolescents.

Reference:

Agency for Healthcare Research and Quality. (2015).
Off-label drugs: What you need to know.

TO PREPARE

· Your Instructor will assign a specific disorder for you to research for this Assignment.

· Use the Walden library to research evidence-based treatments for your assigned disorder in children and adolescents. You will need to recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating this disorder in children and adolescents.

THE ASSIGNMENT (1–2 PAGES)

· Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents.

· Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?

· Explain whether clinical practice guidelines exist for this disorder and, if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.

· Support your reasoning with at least three scholarly resources, one each on the FDA-approved drug, the off-label, and a non-medication intervention for the disorder. Attach the PDFs of your sources.

BY DAY 7 OF WEEK 3

Submit your Assignment.

· Hilt, R. J., & Nussbaum, A. M. (2025).
DSM-5-TR pocket guide for child and adolescent mental health . American Psychiatric Association Publishing.

· Chapter 7, “Reaching a DSM-5-TR Pediatric Diagnosis When You Have 45 Minutes or More” (pp. 185 – 186)

· Chapter 10, “Organizing a Comprehensive Pediatric Mental Status Examination With a Psychiatric Glossary” (pp. 213 – 217)

· Chapter 11, “Using DSM-5-TR Assessment Measures to Aid Diagnosis” (pp. 221 – 248)

· Chapter 15, “Initiating Psychosocial Interventions” (pp. 285 – 294)

· Chapter 16, “Starting Psychotherapy” (pp. 295 – 302)

· Chapter 17, “Initiating Medications and Monitoring for Adverse Effects” (pp. 303 – 330)

· Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015).
Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.

· Chapter 43, “Pharmacological, Medically-Led and Related Treatments”

· Walden University. (n.d.).

Developing SMART goals
Links to an external site.
. to an external site.

· Zakhari, R. (2020).
The psychiatric-mental health nurse practitioner certification review manual . Springer.

· Chapter 5, “Psychopharmacology”

· CriticalThinkRx. (2019, June 9).

Module 5:

Links to an external site.

Specific drug classes: Focus on adverse effects
Links to an external site.

[Video]. YouTube. to an external site.

· CriticalThinkRx. (2019, June 9).

Module 2: Use of psychotropics with youth_prevalence and concerns
Links to an external site.
[Video]. YouTube.

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