First AD

Second AD

A. State you cannot work with him if he discontinues his medication

B. Contact his parents to bring them into the next session to discuss concerns about medication nonadherence

C. Review indications and informed consent for each medication to understand his history of treatment and current ambivalence

D. Agree to discontinue medications if he appears stable and keep close clinical watch while building a therapeutic alliance

It is common for young adults to express a desire to discontinue medications taken since childhood.

To encourage treatment adherence, it is appropriate to redo the informed consent process and review indications for each medication. This will remind the patient of how a medication can help him in functioning and reaching goals.

Because the effects and adverse effects that the patient's parents or guardian agreed to in the past may no longer be acceptable, it is important to present the risks and benefits of each medication.

Closely screen for the patient’s current level of substance use, which may have changed with decreased supervision, for the possible impact on regimen adherence, medication levels, and treatment effectiveness.

Challenges of Transitioning From Pediatric to Adult-Oriented Care

,” by Margaret J. Yoon, MD and Maryland Pao, MD, on which this quiz was based.

Psychopharmacology

Child & Adolescent Psychiatry

Quizzes

A 19-year-old new patient comes to you wanting to discontinue all his childhood psychiatric medications. What is the best next step?

Mini Quiz: New Patient Consult

Margaret J. Yoon, MD

Maryland Pao, MD