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Psychotropic medications for highly vulnerable children.

Jennifer L McLaren1,2,3, Erin R Barnett1,2,3,4, Milangel T Concepcion Zayas1

  • 1a Department of Psychiatry , Geisel School of Medicine at Dartmouth , Lebanon , NH , USA.

Expert Opinion on Pharmacotherapy
|March 30, 2018
PubMed
Summary

Many vulnerable children receive psychotropic medications without sufficient evidence. Future research should focus on long-term effectiveness and integrated psychosocial treatments for improved outcomes.

Keywords:
Psychotropic medicationbehavior problemschild welfarechildrendevelopmental disabilitiesmental healthoff-labelpolypharmacytrauma

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Area of Science:

  • Child Psychiatry
  • Pediatric Psychopharmacology
  • Vulnerable Populations

Background:

  • Over 20% of US children face vulnerability due to lack of healthcare and protection.
  • Factors contributing to vulnerability include trauma, poverty, and developmental disabilities.
  • These children are frequently prescribed psychotropic medications, raising significant concerns.

Purpose of the Study:

  • To review the effectiveness and side effects of psychotropic medications in highly vulnerable children.
  • To examine current prescribing trends, including polypharmacy and off-label use.
  • To identify gaps in research and propose future directions for treatment.

Main Methods:

  • Systematic review of the highest-quality evidence.
  • Description of the population of highly vulnerable children.
  • Analysis of psychotropic medication use for common diagnoses in this population.

Main Results:

  • Highly vulnerable children exhibit high rates of psychotropic medication use, including polypharmacy, off-label prescribing, and long-term treatment.
  • These medication practices often occur without concurrent psychosocial interventions.
  • Current evidence does not support these widespread prescribing trends.

Conclusions:

  • Evidence contraindicates current trends in psychotropic medication use for vulnerable children.
  • Future research must prioritize long-term effectiveness trials and polypharmacy studies.
  • Integrating evidence-based, family-centered psychosocial treatments with psychotropic medication is crucial.