An update on adolescent psychopharmacology

Adolescent pediatricians are being asked to assume a larger role in the management of psychiatric disorders. Therefore, dissemination of the knowledge base regarding the use of psychotropic medications to treat these disorders in children and adolescents is critical. This chapter is an update to the previous "Primer on Adolescent Psychopharmacology" by Bailey and Hendren. Many of the disorders that occur in adolescence are associated with significant morbidity and functional impairment. While the evaluation of adolescents involves a careful assessment of the psychosocial milieu and the implementation of an intervention that involves the use of multiple modalities, pharmacotherapy can diminish symptom severity and thereby assist in the process of recovery. Successful pharmacotherapy begins with the development of an active and reciprocal alliance with the patient and family that allows for sharing of critical information and provision of support. The initiation of treatment should include a clear definition of target symptoms, the potential risks and benefits of the proposed intervention, and a discussion that includes a review of the current treatment experiences in both adult and child psychiatry. The establishment of a method that allows for adequate monitoring of both response and side effects is critical. Clearly, this is a field in its infancy. Thus, practitioners must be acutely aware of both the extent and limitations of the existing knowledge base as well as critical need for more controlled studies of these interventions in adolescence.