Psychopharmacologic treatment of aggressive preschoolers: a chart review

Area of Science:

• Child and Adolescent Psychiatry
• Pediatric Psychopharmacology

Background:

• Severe aggression in very young children is a growing concern in child psychiatry.
• Medication is increasingly considered for treating severe aggression in preschoolers, despite limited research.
• Diagnostic uncertainties are common in this age group.

Purpose of the Study:

• To review patient characteristics, diagnoses, and treatment responses in aggressive preschoolers.
• To evaluate the effectiveness of various medications for severe aggression in young children.

Main Methods:

• Chart review of aggressive preschoolers treated at a university child psychiatry outpatient clinic (2001-2004).
• Analysis of diagnoses, prescribed medications, and treatment response ratings.

Main Results:

• Common diagnoses included Attention Deficit Hyperactivity Disorder (ADHD), Disruptive Behavior Disorder, and Posttraumatic Stress Disorder (PTSD).
• A majority of children received medication, most frequently atypical antipsychotics, followed by stimulants and alpha agonists.
• Moderate to marked improvement was observed in most preschoolers treated with medication or combination therapy.

Conclusions:

• Medication, particularly atypical antipsychotics, stimulants, and alpha agonists, appears effective for severe aggression in preschoolers.
• Findings highlight the need for controlled trials to establish evidence-based medication guidelines for this population.