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Pharmacotherapy of Child and Adolescent
Psychiatric Disorders
i
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Pharmacotherapy of
Child and Adolescent
Psychiatric Disorders
EDITED BY
David R. Rosenberg MD
MiriamL.HamburgerEndowedChairofChildPsychiatryandProfessor&ChiefofChild
PsychiatryandPsychologyatWayneStateUniversityandtheChildren’sHospitalofMichigan,
Detroit,MI,USA
Samuel Gershon MD
EmeritusProfessorofPsychiatry,UniversityofPittsburgh,PA,USA
THIRD EDITION
FOREWORD BY NEAL RYAN MD
A John Wiley & Sons, Ltd., Publication
iii
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LibraryofCongressCataloging-in-PublicationData
Pharmacotherapyofchildandadolescentpsychiatricdisorders/[editedby]DavidRosenbergand
SamuelGershon.–3rded.
p.;cm.
Includesbibliographicalreferencesandindex.
ISBN978-0-470-97376-9(cloth)
I.Rosenberg,DavidR.II.Gershon,Samuel.
[DNLM: 1.PsychotropicDrugs–therapeuticuse. 2.Adolescent. 3.Child. 4.MentalDisorders–drug
therapy. 5.Psychotropic
Drugs–pharmacology.QV77.2]
LCclassificationnotassigned
618.92(cid:2)8918–dc23
2011029295
AcataloguerecordforthisbookisavailablefromtheBritishLibrary.
Thisbookispublishedinthefollowingelectronicformats:ePDF9781119958321;
WileyOnlineLibrary9781119958338;ePub9781119961000;Mobi9781119961017
Setin9.5/13ptMeridienbyAptaraInc.,NewDelhi,India
FirstImpression2012
iv
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ToJ,Isa,theHensterandFoo—thereasonsIsmileinsideandout.
DavidR.Rosenberg
v
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Contents
ListofContributors,xv
Foreword,xix
Chapter1 HistoricalPerspectivesonChildandAdolescent
Psychopharmacology,1
SamuelGershon
References,4
Chapter2 PharmacoepidemiologyofPsychotropic
MedicationsinYouth,7
DanielJ.Safer&JulieMagnoZito
Introduction,7
PrevalenceandtrendsformedicationsprescribedforADHD,8
NonstimulantmedicationsforADHD,11
Antidepressantmedication,11
Antipsychoticmedication,13
Alpha-agonists,14
Anticonvulsant“moodstabilizers”,15
Concomitantpsychotropicmedication,15
Preschoolpsychotropicmedicationuse,17
Internationalpatternsofpsychotropicmedicationforyouth,17
Conclusion,18
References,18
Chapter3 Off-LabelPrescribingofDrugsinChildand
AdolescentPsychiatry,25
C.LindsayDeVane
Introduction,25
Extentofoff-labelprescribing,27
vii
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viii Contents
Needforpsychoactivedrugtreatmentsforchildrenand
adolescents,31
Legislationsupportingpediatricdrugdevelopment,33
Recommendationstofollowwhenconsideringoff-label
prescribing,35
References,36
Chapter4 TheUseofGenericDrugsinPediatric
Psychopharmacology,39
RichardI.Shader&Christopher-PaulMilne
Whatisagenericdrug?,39
Whyarewediscussinggenericdrugs?,39
Basicrequirementsforgenericdrugs,40
Thestatusofregulationsregardinggenericdrugsandchildren,41
Abbreviatednewdrugapplication(ANDA)requirements,42
Pediatricassessmentsofadultdrugs(historyupto
currentstatus),43
BestPharmaceuticalsforChildrenAct,44
PediatricResearchEquityAct,45
Intersectionofrequirementsforgenericsandpediatric
assessment,46
Futuredirections,48
Concludingthoughts,49
References,49
Chapter5 PsychoactiveDrugUseinChildren:BasicConcepts
inClinicalPharmacology,51
DavidJ.Edwards
Introduction,51
Basicconceptsinpharmacokinetics,52
Dosingconsiderationsforpsychoactivedrugsinchildren,55
Summary,60
References,60
Chapter6 Psychostimulants,65
StevenR.Pliszka
Introduction,65
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Contents ix
Epidemiologyofstimulantuse,66
Structureandbiochemicalmechanismofaction,66
Neuroimagingstudiesofstimulanteffects,67
Studiesofshort-termefficacy,72
Studiesoflong-termefficacy,76
Clinicaluse,79
Commonside-effects,84
Cardiovascularsafetyissues,86
Growthsuppression,88
Substanceuseanddiversion,88
Comparisonwithnonstimulanttreatment,89
Treatmentofcomorbidity,92
Pharmacogenetics,93
Conclusions,94
References,94
Chapter7 TricyclicAntidepressantsandMonoamineOxidase
InhibitorsfortheTreatmentofChildandAdolescent
PsychiatricDisorders,105
CharlotteM.Heleniak,TejalKaur,KareemD.Ghalib&MoiraA.Rynn
Tricyclicantidepressants(TCAs),105
Druginteractions,contraindications,116
Monoamineoxidaseinhibitors(MAOIs),117
Generalsummary,122
References,123
Chapter8 SelectiveSerotoninReuptakeInhibitors
(SSRIs),131
DaraSakolsky&BorisBirmaher
Pharmacokinetics,131
Initiationandtitration,133
Indicationsandefficacy,134
Adverseeffects,146
Withdrawal,149
References,149
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x Contents
Chapter9 Novel(Atypical)Antidepressants,155
HeidiR.Bruty,GrahamJ.Emslie&PaulCroarkin
Novel(atypical)antidepressants,155
Generaloverview,155
Bupropion,157
Duloxetine,162
Mirtazapine,164
Trazodone,166
Venlafaxine,170
Desvenlafaxine,173
Alternativetreatments,174
Summary,175
References,176
Chapter10 AntipsychoticAgents,181
BrieanaM.Rowles,JohnL.Hertzer&RobertL.Findling
Introduction,181
Chemicalproperties,182
Typicalantipsychotics,183
Atypicalantipsychotics,186
Ethicalissues:treatmentofat-riskpopulations,212
Conclusions,213
References,213
Chapter11 Lithium,221
GarrettM.Sparks&DavidA.Axelson
Introduction,221
Pharmacology,222
Potentialmechanismsofaction,222
Evidencefortheuseoflithiuminchildrenandadolescents,232
Dosinganddrugmonitoring,239
Contraindications,precautions,anddruginteractions,242
Side-effects,246
References,250
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Contents xi
Chapter12 AnticonvulsantsUsedinChildandAdolescent
PsychiatricDisorders,261
ManiPavuluri&TushitaMayanil
Introduction,261
Divalproexsodium,261
Carbamazepine,271
Oxcarbazepine,275
Lamotrigine,279
Gabapentin,284
Topiramate,285
Conclusion,288
References,288
Chapter13 Anxiolytics,301
BarbaraJ.Coffey&AmandaL.Zwilling
Chemicalproperties,301
Indications,305
Contraindications,320
Adverseeffects,321
Overdose,324
Abuse/dependence,324
Druginteractions,325
Availablepreparationsandcost,325
Initiationandmaintenanceoftreatment,325
Managementofspecificside-effects,330
Howtowithdrawmedication,332
References,332
Chapter14 AdrenergicAgentsinChildandAdolescent
Psychiatry,341
LawrenceDavidScahill
Clonidineandguanfacine,341
Guanfacine,349
Beta-blockers,355
Acknowledgements,361
References,361
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xii Contents
Chapter15 AtypicalPsychopharmacologicStrategies,365
JessShatkin&AronJanssen
Opiateantagonists,365
Memantine,368
Riluzole,369
Secretin,371
Topiramate,372
Herbalmedicationsanddietarysupplements,373
Ginkgo(Ginkgobiloba),375
Melatonin,381
Omega-3fattyacids,383
St.John’swort(Hypericumperforatum),384
Valerian(Valerianaofficinalis),387
Conclusion,388
References,389
Chapter16 PsychopharmacologyinPreschoolChildren,399
MiniTandon&JoanLuby
Introduction,399
Developmentalconsiderations,400
Riseinpsychopharmacologyuse,402
Psychotherapybeforepsychopharmacology,403
Whenpsychopharmacologymaybeconsideredasafirstline:
pragmaticconsiderations,404
Psychopharmacologyinpreschooldisorders:administrationand
monitoring,404
Off-labelprescribing:specialconsiderations,407
Useofpsychotropicsinspecificdisorders,408
Summary,415
References,415
Chapter17 CombinationPharmacotherapyforPsychiatric
DisordersinChildrenandAdolescents,421
GaganJoshi&AnnaM.Georgiopoulos
Bipolardisorder,422
Description:This book fulfils an urgent need for an updated text on pediatric psychopharmacology. It takes a unique approach in discussing recent findings within the context of current issues, including economic and political ones. The book covers the emerging question of treating children who do not yet meet d