Evidence-based psychopharmacology for children and adolescents

Purpose of review To provide an update of recent advances in child and adolescent psychopharmacology. Recent findings Changes in legislation in the United States and increased funding by the National Institute for Mental Health has led to a rapid increase in both the number and quality of clinical trials in child and adolescent psychiatry. Recent advances in the psychopharmacology of attention deficit hyperactivity disorder, depression, bipolar disorder, anxiety, obsessive compulsive disorder and autism are reviewed, and continuing gaps in knowledge are noted. Randomized controlled trials have been published supporting the use of modified release stimulant preparations and non-stimulant agents in attention deficit hyperactivity disorder and selective serotonin reuptake inhibitors in depression, anxiety disorders and obsessive compulsive disorders. Secondary analyses of the Multisite Multimodal Treatment Study of Children with Attention-Deficit Hyperactivity Disorder and evidence-based guidelines have given pointers towards more effective treatments for attention-deficit hyperactivity disorder. Pre-clinical studies that have made significant contributions to our theoretical understanding of both the pathophysiology and treatment of these child and adolescent psychiatric disorders are noted. Summary There is now significantly more evidence available to support the rational prescribing of psychoactive agents for several child and adolescent psychiatric disorders. However, there are still many gaps in our knowledge and further studies are required before it will be possible to practise in a truly evidence-based manner.