In the pediatric population, second-generation antipsychotic medications are approved for diagnoses of autism, schizophrenia and bipolar disorder and are often used for off-label indications. During the past decade, an overall increase in pediatric use of second generation atypical antipsychotic medications has occurred due to convincing evidence that this class of medications is effective for reducing aggression and irritability in this population with psychiatric disorders. Up to 1 out of 5 (13-20%) children experience a mental disorder in a given year. The use of concurrent antipsychotic medications increases the likelihood of adverse drug reactions and the risk of drug-drug interactions. Antipsychotic medications can also cause weight gain, drowsiness and increase the risk of developing hyperglycemia, hyperlipidemia, and hyperprolactinemia.

Safe and effective use of this class of medications depends on appropriate medication monitoring. Provider adherence to medication monitoring is low due to barriers which include: familiarity with ordering and interpreting results, and confusion over responsibility for metabolic monitoring.

For these reasons, children and adolescents on antipsychotic medications can benefit significantly from a pharmacist-led drug therapy management (DTM) program. Our targeted DTM program monitors patients on behavioral health medications, focusing on appropriate specialist follow up, laboratory values, drug-drug interactions, adverse drug effects, adherence, and optimizing medication regimens. Pharmacists work with patients, their legal guardians, providers, and case managers to assist in these medication-related problems to ultimately improve member outcomes, decrease overall healthcare expenditures, and close gaps in care.