Psychopharmacology of disorders in children

Several features of pediatric pharmacology applied to psychiatry were mentioned throughout this review. The use of medications in young children requires attention to nuances of informed consent because of limited data and many potentially beneficial, possibly safer medications that are not approved for children. Children more rapidly metabolize and eliminate medications. They differ in sensitivity to main effects and side effects of a variety of medications. Therefore, it is important to start low and aim for the lowest effective dose. Ultimate doses may be higher, split and frequent doses may be necessary, and both clinical and laboratory follow-up may need to be more frequent. Finally, childhood onset of psychiatric disorders, similar to pediatric experience with diabetes or rheumatoid arthritis, frequently confers devastating stress and chronicity. The child's physician shares the frustration of poor treatment response or responses that cannot be sustained in a developing, dependent organism with a more aggressive variant of a disorder and an inevitably longer course. Despite a heartening increase in pediatric psychopharmacology interest and knowledge, much remains to be learned.