Green’s Child and Adolescent Clinical Psychopharmacology

426 Pages·2013·5.55 MB·English

by  William Klykylo

Green’s Child and adolesCent
CliniCal PsyChoPharmaColoGy
(c) 2014 Wolters Kluwer. All Rights Reserved.

Green’S Child and adoleSCent
CliniCal PSyChoPharmaColoGy
5TH EDITION
William m. KlyKylo, am, mD chRistina Weston, mD
Professor and Director Associate Professor
Division of Child and Adolescent Psychiatry Division of Child and Adolescent Psychiatry
Wright State University Boonshoft Wright State University Boonshoft
School of Medicine School of Medicine
Dayton, Ohio Dayton, Ohio
RicK BoWeRs, mD Julia JacKson, mD
Clinical Associate Professor Assistant Professor
Division of Child and Adolescent Psychiatry Division of Child and Adolescent Psychiatry
Wright State University Boonshoft Wright State University Boonshoft
School of Medicine School of Medicine
Dayton, Ohio Dayton, Ohio
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Library of congress cataloging-in-publication Data
Klykylo, William M., author.
Green’s child and adolescent clinical psychopharmacology / William M. Klykylo.—Fifth edition.
p. ; cm.
Child and adolescent clinical psychopharmacology
Preceded by Child and adolescent clinical psychopharmacology / Wayne Hugo Green. 4th ed. c2007.
Includes bibliographical references and index.
ISBN 978-1-4511-0714-2—ISBN 1-4511-0714-5
I. Green, Wayne H. Child and adolescent clinical psychopharmacology. Preceded by (work):
II. Title. III. Title: Child and adolescent clinical psychopharmacology.
[DNLM: 1. Mental Disorders—drug therapy. 2. Adolescent. 3. Child. 4. Psychopharmacology—
methods. 5. Psychotropic Drugs—therapeutic use. WS 350.2]
RC483
616.89'18—dc23
2013018393
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ally accepted practices. However, the authors, editors, and publisher are not responsible for errors
or omissions or for any consequences from application of the information in this book and make no
warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the con-
tents of the publication. Application of the information in a particular situation remains the profes-
sional responsibility of the practitioner.
The authors, editors, and publisher have exerted every effort to ensure that drug selection and
dosage set forth in this text are in accordance with current recommendations and practice at the time
of publication. However, in view of ongoing research, changes in government regulations, and the
constant flow of information relating to drug therapy and drug reactions, the reader is urged to check
the package insert for each drug for any change in indications and dosage and for added warnings
and precautions. This is particularly important when the recommended agent is a new or infrequently
employed drug.
Some drugs and medical devices presented in the publication have Food and Drug Administration
(FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care
provider to ascertain the FDA status of each drug or device planned for use in their clinical practice.
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(c) 2014 Wolters Kluwer. All Rights Reserved.
To our teachers, our students, our patients,
and our families, and to Wayne Hugo Green
(c) 2014 Wolters Kluwer. All Rights Reserved.

Contributor
Ryan Mast, MBA, DO
Assistant Professor
Division of Child and Adolescent Psychiatry
Wright State University Boonshoft
School of Medicine
Dayton, Ohio
vii
(c) 2014 Wolters Kluwer. All Rights Reserved.
Preface
It has been both a great honor and a daunting challenge to prepare a fifth edition of
Wayne Hugo Green’s seminal Child and Adolescent Clinical Psychopharmacology.
Words cannot express our respect for Dr. Green’s magnum opus; perhaps it is best
demonstrated by our efforts as four editors to revisit what Dr. Green has done by
himself through four editions. This book has exerted a major beneficial influence
on the conduct of our specialty and the care of our patients, and we have endeav-
ored to be worthy of this tradition.
We have maintained Dr. Green’s attention to FDA Black Box and Bold Print
warnings, as increasing evidence appears that modern psychopharmacology, de-
spite its great benefits, is no more exempt from adversity than other medical in-
terventions. Modern agents are not without undesirable effects in some cases, and
they are never panaceas or replacements for psychosocial and educational inter-
ventions. The possibility of misadventure becomes increasingly apparent as more
of these agents are administered to more children. At the same time, however, the
increasing use of these medications is also an indication of their utility and promise
to children. We have approached this book as we approach our clinical work, with
optimism balanced by realistic expectations and clinical caution.
The general format of this book has been carried on from previous editions,
but with some modifications. Notably, drugs used to enhance attentional function
are now grouped together. A number of older drugs that are less commonly used
today are covered in an appendix. We have done this in the interest of utility and
not as a disparagement of the continued value and frequent cost-effectiveness of
these agents for some patients. We have included mention of thioridazine not as
endorsement but in recognition of the use of that agent by a few practitioners.
Since the last edition, there has been an increase in the number of extended-release
psychostimulant preparations and of new second-generation antipsychotic drugs,
and these are noted herein. Child and adolescent psychopharmacology has largely
been conducted on an “off-label” basis, but with evolving research, an increasing
number of indications for specific drugs have been approved by the FDA, and we
have recognized these. Inevitably, indications (and possible contraindications) will
continue to appear after any book goes to print, and the reader is strongly encour-
aged to maintain currency with www.fda.gov and related sources. Finally, in view
of the growing recognition of the moral as well as legal challenges related to the
use of psychotropic medication in minors, we have added a section on the ethics of
psychopharmacology.
ix
(c) 2014 Wolters Kluwer. All Rights Reserved.
x Preface
We hope that this edition will continue the book’s tradition of authority and
utility. Whatever its merits, preparing it required the help of many others. Dr. Green
has been personally supportive, and we would not have undertaken this project
without his kind encouragement. The staff of Lippincott Williams & Wilkins, most
notably Tom Gibbons, have made our work pleasurable through their encour-
agement, advice, and patience. Here at Wright State University, Megan Schwartz
assisted with research and Elizabeth Huber employed her very considerable edito-
rial abilities in organizing our texts and references. No such work as this could
ever come about without the assistance of our colleagues and the tolerance of our
families, to whom we are forever in debt.
WMK, RB, CGW, JJ
(c) 2014 Wolters Kluwer. All Rights Reserved.