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Anxiolytics, adrenergic agents, and naltrexone.

M A Riddle¹, G A Bernstein, E H Cook

¹Division of Child and Adolescent Psychiatry, Johns Hopkins Medical Institutions, Baltimore, MD, USA.

Journal of the American Academy of Child and Adolescent Psychiatry

|May 7, 1999

Summary

Limited controlled data support the efficacy of many psychiatric medications for children and adolescents. Further research is crucial to establish safety and effectiveness for conditions like anxiety, ADHD, and autistic disorder.

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Area of Science:

Pediatric Psychiatry
Psychopharmacology
Child and Adolescent Mental Health

Background:

Review of medications used for pediatric psychopathologies.
Focus on anxiolytics, adrenergic agents, and opiate antagonists.
Assessment of existing efficacy and safety data.

Purpose of the Study:

Evaluate current evidence for psychotropic medications in youth.
Identify gaps in research on drug efficacy and safety.
Guide future research directions in pediatric psychopharmacology.

Main Methods:

Systematic review of controlled trials up to 1997.
Inclusion of English-language publications.
Consideration of selected uncontrolled studies.

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Main Results:

Scarcity of controlled data supporting drug efficacy in children and adolescents.
Lack of controlled studies for some drugs (e.g., buspirone, guanfacine).
Placebo-controlled studies failed to demonstrate efficacy for others (e.g., clonidine, naltrexone).

Conclusions:

Benzodiazepines recommended for acute anxiety in youth.
Buspirone and serotonin 1A agonists suggested for anxiety and depression.
Beta-blockers for aggressive dyscontrol, guanfacine for ADHD, naltrexone for autistic disorder symptoms.