Pharmacotherapy in Psychiatric Disorders of Children: Current Evidence and Trends

Abstract

Pharmacotherapeutic interventions are available for most psychiatric disorders in children. Evidence for these interventions varies, depending on the targeted disorders. For attention-deficit/hyperactivity disorder, a sound database on efficacy and safety of medication exists. For other common disorders or psychopathological phenomena like disruptive behavior, anxiety disorders, depressive disorders, or autism, data on efficacy and safety are much scarcer. This selective review aims to provide an overview about current psychopharmacological interventions in child and adolescent psychiatry. The literature indicates either a lower efficacy than other interventions or less beneficial effects compared to possible adverse events in these cases. Most guidelines recommend psychopharmacotherapy in children to be embedded in a psychosocial or therapeutic intervention plan. Decision for medication depends on the severity of symptoms, chronicity, and, most important, impairment of the child in academic performance, family relationships, and everyday life. The high rates of off-label use in the age group of children are often due to a lack of market authorization studies less indicative of low efficacy. As adverse events need to be monitored closely, pharmacotherapy should mainly be restricted to experienced mental health care providers.

Medicinal Use of Cannabis in Children and Pregnant Women

“…Conventional medical treatment includes various psychotropic medications such as atypical antipsychotics, selective serotonin reuptake inhibitors (SSRIs), stimulants, and anxiolytics. 2 However, use of these medications for ASD is often not effective and is commonly associated with adverse drug reactions.…”

The controversy around a mood stabilizer. The history of lithium

“…Jest to niezbędny składnik do transportu witaminy B12 i kwasu foliowego, a najnowsze badania wskazują na jego zdolność do regulowania neurotrofin (np. BDNF) 26 .…”

From Psychopharmacological Evidence to Clinical Practice: Unmet Needs in Child & Adolescent Psychiatry – Reflections on Kölch & Plener

“…Treatment research has focused primarily on acute treatment, yet many disorders, such as ADHD or early-onset depression, are frequently chronic or recurrent. As Kölch and Plener [1] themselves point out, pharmacological treatment, although often highly effective in the short term, lacks proven long-term efficacy and presents substantial variability in clinical treatment outcome, optimal dosage, and tolerability. Examples from the most prevalent disorders may exemplify this challenge: In youth with depression, remission rates are low, despite a huge increase in treatment research in the past 20 years.…”

“…Research in clinical psychopharmacology has advanced the evidence base for the treatment of various child psychiatric disorders. In their selective review in this journal, Kölch and Plener [1] relate the efforts that have been made in recent decades. Although the available studies provide invaluable insights into effects, adverse events, and mechanisms of psychotropic drugs in children and youth, clinical practice requires further steps, some of which will be reflected in this commentary.…”