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Criteria for inclusion in the review are presented and include aspects of study design placebo-controlled, large sample size , source of funding government funded vs. Data for short-term efficacy, long-term efficacy, effectiveness, and safety and adverse events are discussed for each class of medication, although for many, there remains little empirical data. Findings for stimulants, selective serotonin reuptake inhibitors, neuroleptics, alpha-adrenergic agonists, mood stabilizers, buproprion, secretin, naltrexone, immune therapies, and natural supplements are all presented. Finally, the authors offer some speculations regarding the future of pediatric psychopharmacology research.
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Log in Register. Export citation. Corresponding author Requests for reprints to: Mark A.
What are the implications of treating an individual with a placebo when that individual has a condition for which medication has been proven effective? These important questions are not addressed. At times the writers take a paternalistic attitude towards treatment methodology. In my opinion, there are two problems with this position. First, it discounts the results of recent placebo controlled randomized clinical trials on the treatment of pediatric depression, which show that medications are well tolerated and effective in the treatment of pediatric depression independent of psychotherapy.
The efficacy of both fluoxetine Prozac and paroxetine Paxil have been validated through this research Keller , Emslie Medications are a reasonably safe and effective treatment for depression.
Pediatric Psychopharmacology for Primary Care
Patients and their families should be informed of this, and should they choose this option, treatment with medication should be facilitated in an appropriate environment. To relegate psychopharmacologic interventions to an adjunctive role to therapy fails to take into account the scientific support for medication treatment, and denies patients the right to choose for themselves the method s of treatment with which they are most comfortable.
Parts of the book revealed a surprising number of errors, some of which were merely annoying and others that were frankly misleading.
There are multiple incidences of medication names or trade names being misspelled. More concerning is a chart summarizing medications for ADHD where the authors list appetite suppression as an adverse effect of dextroamphetamine and methylphenidate p. However, in the same chart they do not list appetite suppression as a side effect of Adderall a combination of dextroamphetamine and racemic amphetamine.
This error could easily lead a reader to falsely believe that Adderall does not suppress appetite, even though this is a well-known and common side effect. Finally, errors in a chart summarizing medications used for treating tics are potentially dangerous p.
As some of these medications have serious cardiovascular effects, children could be gravely harmed if a physician or other practitioner unfamiliar with these medications were to use this chart as a reference in prescribing or administering them. The difference between treating a 20 kg child with 0. Whether these errors are due to careless proofreading or to a lack of experience and knowledge of the subject, they are misleading and possibly dangerous.
This book has areas of strength. It is well referenced, with citations listed at the end of each chapter. Chapter Three includes an excellent section on overcoming barriers to treatment via education, support, collaboration, and community based services. Furthermore, the discussion of social validity as a potential obstacle to treatment captures the importance of recognizing how cultural factors can influence treatment on an individual or family level.
Mental health professionals need to collaborate to increase the awareness of mental illnesses as treatable conditions, improve the quality of treatments available, and conduct research to develop new treatment options. This book offers useful information about how to collaborate as well as ways to use rating instruments in the treatment process. But it lacks the very collaborative attitude it recommends to others, and contains numerous and significant errors.
Pediatric Psychopharmacology for Primary Care Digital Tool
A double-blind, randomized, placebo-controlled trial of fluoxetine in children and adolescents with depression. Archives of General Psychiatry, Nov , 54 11 : Christopher A. Lamps, M. Brown, and Thomas J.
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