Adolescence phases

The first phase (Phase I) in a woman s reproductive ontogeny usually begins during adolescence and is a process of meeting a succession of males, first to assess their potential as partners and secondly to attract them to provide company, support, protection and... 

IN addition to covering traditional areas such as mechanism of action, structure-function relationships, and drug disposition and toxicity, this part of the volume reviews drug-specific data that are specifically pertinent to children and adolescents. Age and developmental phase as critical variables relevant to dosing schemes and side effect liabilities are two recurring themes. Clinical mechanics for using these... 

In a recent pilot study, 16 out of 22 (72%) adolescents with BD treated with additional lamotrigine during their depressed phase responded to treatment by the end of week 4 this suggests that lamotrigine might be useful in adolescent bipolar depression. (Kusumakar and Yathan, 1997). 

Within each cell, informants are listed in approximate order of importance and /or desirability. Parent should be understood broadly as primary care-giver(s), including residential center staff. Prepubertal children phase into the adolescent priorities about ages 10-12 years (transition from concrete operations to formal operations). For patients with mental retardation or pervasive developmental disorder, mental age and communication ability must be considered. ... 

If at the end of the continuation phase it is decided that the antidepressants should be discontinued, this should be done gradually (e.g., over 6 weeks) to avoid withdrawal effects such as sleep disturbance, irritability, or gastrointestinal symptoms, which may lead the clinician to misinterpret the need for continued medication treatment. Clinical practice has suggested that rapid discontinuation of antidepressants may precipitate a relapse or recurrence of depression. In children and adolescents, it is recommended that treatment be discontinued while they are on extended vacations, rather than during the school year. 

Brent, D.A., Kolko, D., Birmaher, B., Baugher, M., and Bridge, J. (1999b) A clinical trial for adolescent depression predictors of additional treatment in the acute and follow-up phases of the trial. / Am Acad Child Adolesc Psychiatry 38 263-270. 

As an example of potential clinical application of the proposed theoretical model, preliminary results of a phase I clinical trial are described below. We estimated the values of relaxation time and ratio Max/Max in adolescents with different results of endoscopy. We found that the mean relaxation time was significantly longer in subjects with a severe gastric and duodenal inflammation, namely, with ulcers and erosions compared to a healthy control group (p<0.05). The exhaled air of patients with milder forms of the disease and of the control group caused faster sensor relaxation after their interaction (Table 7.1). 

As mentioned earlier, the clinical trials with TCAs in children and adolescents with MDD have generally been disappointing ( 120, 122,123). In addition, these medications have a less favorable adverse effect profile and thus higher patient attrition rates during the acute treatment phase compared with newer antidepressants. They also have a lower therapeutic index (i.e., difference between therapeutic and toxic dose see Chapter 7). 

Although the usefulness of the atypical antipsychotics is best documented for the positive symptoms of schizophrenia, numerous studies are documenting the utility of these agents for the treatment of positive symptoms associated with several other disorders (discussed in Chapter 10 see Fig. 10—2). Atypical antipsychotics have become first-line acute and maintenance treatments for positive symptoms of psychosis, not only in schizophrenia but also in the acute manic and mixed manic-depressed phases of bipolar disorder in depressive psychosis and schizoaffective disorder in psychosis associated with behavioral disturbances in cognitive disorders such as Alzheimer s disease, Parkinson s disease, and other organic psychoses and in psychotic disorders in children and adolescents (Fig. 11—52, first-line treatments). In fact, current treatment standards have evolved in many countries so that atypical antipsychotics have largely replaced conventional antipsychotics for the treatment of positive psychotic symptoms except in a few specific clinical situations. 

Pelayo RP, Thorpy MJ, Glovinsky P. Prevalence of delayed sleep phase syndrome among adolescents. J Sleep Res 1988 17 392. 

Sleep disorders such as sleep apnea, narcolepsy, delayed sleep-phase syndrome (DSPS), and insomnia can cause problem sleepiness and difficulty functioning during the day for adolescents (103). Over the course of several studies, Roberts and colleagues have shown that insomnia and related sleep problems have adverse consequences for the future functioning of adolescents (107,108). In particular, insomnia symptoms such as nonrestorative sleep, difficulty initiating sleep, and daytime sleepiness predicted self-esteem difficulties, interpersonal relationship problems, and symptoms of depression, along with somatic complaints (108). 

Thorpy MJ, Korman E, Speilman AJ, Glovinsky PB. Delayed sleep phase syndrome in adolescents. J Adolesc Health Care 1988 9(l) 22-27. 

Fox E et al (2010) A phase 1 trial and pharmacokinetic study of cediranib, an orally bioavail-able pan-vascular endothelial growth factor receptor inhibitor, in children and adolescents with refractory solid tumors. J Clin Oncol 28 5174-5181... 

A period of experimentation with drugs is today a normal phase of adolescence— a rite of passage that most children pass through unscathed. 

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