Brief Answer:
Please find detailed answer below

Detailed Answer:
Hi XXXXXXX
Thanks for writing in to us.

I have read through your query in detail.

Saphris:
Saphris (Asenapine) is presently not recommended for children below 18 years of age.
This medication has FDA approval in treating adults.

Side effects of taking Saphris might include:
1. Hypersensitivity reactions (fatal), including anaphylaxis and angioedema, have been observed in patients treated with asenapine. In several cases, these reactions occurred after the first dose. These hypersensitivity reactions included: anaphylaxis, angioedema, hypotension, tachycardia, swollen tongue, dyspnea, wheezing and rash.

2. Other Findings: Oral hypoesthesia and/or oral paraesthesia may occur directly after administration of asenapine and usually resolves within 1 hour.

3. The following adverse reactions have been identified during post-approval use of SAPHRIS. Application site reactions, primarily in the sublingual area, have been reported. These application site reactions included oral ulcers, blisters, peeling/sloughing, and inflammation. In many cases, the occurrence of these application site reactions led to discontinuation of therapy.

Seroquel:
Seroquel (quetiapine) is a psychotropic medication that is used to treat psychiatric disorders including mania and schizophrenia in adults and children who are at least 13 years old with FDA approval. SEROQUEL is not approved for use in pediatric patients under ten years of age.

Side effects of seroquel:

1. Stroke that can lead to death can happen in elderly people with dementia who take medicines like SEROQUEL

2. Neuroleptic malignant syndrome (NMS). NMS is a rare but very serious condition that can happen in people who take antipsychotic medicines, including SEROQUEL. NMS can cause death and must be treated in a hospital. Call your healthcare provider right away if you become severely ill and have some or all of these symptoms:
high fever
excessive sweating
rigid muscles
confusion
changes in your breathing, heartbeat, and blood pressure

3. Movements you cannot control in your face, tongue, or other body parts (tardive dyskinesia).

In Children and Adolescents the most common side effects of SEROQUEL include:
• nausea
• increased appetite
• dry mouth
• vomiting
• weight gain
• rapid heart beat

As Saphris is not meant for children below 18 years of age, there are no alternatives. Seroquel must be carefully prescribed in children. There is no completely safe medication. Each medication has its own mechanism of action and adverse effects. We at WWW.WWWW.WW follow E health policy by which we do not suggest any particular medication. Should you require information on any particular medication, we will be glad to help you.

I hope this helps.
Do write back in case of doubts.

Dr.A.Rao Kavoor

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Brief Answer:
All drugs available have their own side effects.

Detailed Answer:
Hi,
Thanks for writing back,

Treatment of children and teenagers has not been as extensively studied as that in adults that is the reason it is not approved by the FDA. But it does not mean there is no evidence of their efficiency in children/teenagers. It is prescribed with caution after weighing their benefits and risks. Choices of drugs depend on the psychiatric history, the number of episodes of mania/depression in the past, family history, side effect profile in relation to the particular patient etc. The theoretically listed side effects are quite rare. In practice the most common troubling side effect are extra-pyramidal side effects which is comparatively the least in quetiapine than all the other options available. Two antipsychotics are necessary only when the first one fails to show adequate response. In Bipolar disorder the usually prescribed drug is also a mood stabilizer (in acute stages, apart from an antipsychotic) like Sodium Valproate, Lithium and carbamazepine etc. These drugs are used during the maintenance stage for long term without an antipsychotic. But they are not without side effects either. Quetiapine is also known to have mood stabilizing properties and is used for this reason in many patients. Currently all the drugs available for this disorder have side effects and are prescribed after weighing the risk and benefits. And presently you also say she continues to have auditory hallucinations that compel her to hurt herself and treating this should be our first priority at the time being. If she is distressed with this symptom and has insight into the fact that the cause of the voices is her illness then as an adjunt, you could try some psychological treatments (therapies) to decrease the hallucinations or reduce her acting out on it. In acute stages, medications are necessary, once she recovers from this stage, very low dose of medications can be continued.

I hope this helps,
Dr. A Rao Kavoor

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