HuBio 564: Principles of Pharmacology II
Case Study 4
Jason, an 8 year old boy, is brought to your primary care clinic by his mother for concerns over his behavior at school and at home. His mother states that he has always had difficulty with being loud, following rules, and has a hard time finishing his academic work. These difficulties were apparent in kindergarten and first grade, but they have been a greater concern to his second year teacher, who apparently told Mom that his behavior is causing a disruption in the class. Mom read the book "The Bipolar Child", and is worried that some of Jason's behaviors, like threatening his sister, being excessively silly and his fascination with violent video games, might be symptoms of bipolar disorder.
Jason reports that he does not like his teacher and feels she is mean. He also feels that his homework is too hard for him and that he doesn't understand it. He also reports that is little sister is annoying. During the appointment, Jason spends most of the time staring sadly at the floor, and says very little, shaking his head "no" a great deal when his mother is describing his behavior.
Questions to address:
1. What is the differential diagnosis?
2. What medications should be considered to treat his symptoms? If you decided to use a medication, how would you prescribe it.
3. What psychosocial factors might contribute to medication decisions?
4. For each of the medications considered, what types of symptoms and side effect monitoring is needed?
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