ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Psychological Therapy and Psychosomatics
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1560873
This article is part of the Research TopicFunctional Neurological Disorders and Functional Dissociative Seizures: Bridging Neurological Insights and Psychiatric CareView all articles
The adjunct role of pharmacotherapy in multimodal treatment of paediatric functional neurological disorder
Provisionally accepted
- 1Children's Hospital at Westmead, Sydney, New South Wales, Australia
- 2Center School of Psychological Sciences, University of Tasmania, Launceston, Australia
- 3Child Youth Mental Health Service North (CYMHSN), Launceston, Tasmania, Australia
- 4Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, United States
- 5University of Sydney medical school, Camperdown, NSW, Australia
- 6Westmead Institute for Medical Research, Sydney, New South Wales, Australia
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Abstract (please note we would like to use UK English) 200 words Background: Rehabilitation for children with functional neurological disorder (FND) requires a biopsychosocial intervention: physiotherapy, psychotherapy, pharmacotherapy, school attendance, and family work. This study documents the pharmacotherapeutic element and its rationale. Methods: Medication use was documented in 158 children with FND (41boys, 117 girls, mean 13.78) admitted into the Mind-Body Program. Results: On presentation, children with FND had high levels of functional impairment, school loss, and comorbid psychiatric, functional, and medical disorders. On admission, 63% (n=95) were on medications. During admission, 130 (82.3%) children had pharmacotherapy interventions: dose adjustment, initiation, or discontinuation. 88.6% (n=140) were discharged on medications. Pharmacotherapy targets included: antidepressants for anxiety/depression (n=111; 70.3%); antipsychotics for extreme anxiety/arousal (n=73; 46.2 %); melatonin for sleep (n=64; 40.5%); α agonists and β blockers, for arousal, sleep initiation, and trauma-related nightmares (n=58; 36.7%); iron/vitamin supplementation (n=30; 19.0%); and medications for functional gut symptoms (n=28; 17.7%) and comorbid pain (n=20; 12.7%). Conclusions: Pharmacotherapy is used as an adjunct in paediatric FND to down-regulate the stress system, reset the circadian clock, manage pain, and treat comorbid disorders. Pharmacotherapy and its concomitant placebo effects scaffold the child to enable engagement in all components of the therapeutic process and return to healthy function.
Keywords: Arousal, Child, functional neurological (conversion) disorder (FND), medication, functional/dissociative seizures, sleep problems, Psychiatry, Rehabilitation
Received: 15 Jan 2025; Accepted: 09 Jun 2025.
Copyright: © 2025 Cummins, Hawkes, Longworth, Scher and Kozlowska. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Kasia Kozlowska, Children's Hospital at Westmead, Sydney, 2145, New South Wales, Australia
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