A Pediatric Psychopharmacology Desk Reference

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Abstract

Reviews the book, Pediatric Psychopharmacology: Fast Facts by Daniel F. Connor and Bruce M. Meltzer (see record 2006-01561-000). For those who already prescribe or those who are preparing to do so, Pediatric Psychopharmacology: Fast Facts is exceptionally useful in helping a wide range of pediatric mental health professionals understand the medical issues inherent in pediatric psychopharmacology. One of the text's primary strengths is its coverage of the current state of scientific evidence in this field. Readers may find themselves comforted (or unsettled) by the authors' forthright statement that “presently, the scientific evidence base in pediatric psychopharmacology is inadequate to support the level of clinical prescribing in this area” (p. 8). In this same introductory section, the authors outline the history of psychopharmacology with pediatric patients, the Food and Drug Administration (FDA) approval process, “off-label prescribing” in pediatric psychopharmacology, or the now-frequent practice of prescribing drugs for purposes other than those the FDA has formally approved. In addition, the authors do not fail to overlook concerns related to the effects of psychotropic medications on pediatric patients' developing neurological and cognitive systems. The authors make abundantly clear in the text's opening chapters that effective and responsible practice includes not only comprehensive assessment and follow-up but multiple perspectives on a child's functioning. The authors describe the limitations of current diagnostic systems with pediatric patients, cautioning prescribing clinicians to focus primarily on symptom presentation rather than on a specific diagnostic category. In addition, the authors encourage practitioners to consider overall context and functioning in case conceptualization and treatment planning. The second section of the text contains 10 chapters focusing specifically on the hundreds of available medications used in pediatric psychopharmacology. Each chapter is structured around a specific medication class, such as antidepressants, stimulants, mood stabilizers, antipsychotics, and even herbal remedies. The text's final section contains chapters on treatment of specific diagnoses, including the major Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) categories such as attention deficit/hyperactivity disorder (ADHD), Tourette's syndrome and other tic disorders, disruptive disorders, mood disorders, developmental disorders, and disorders of self-regulation. The final chapter, “Other Issues,” provides an overview of the major challenges facing today's pediatric psychopharmacological prescribers. As an academic psychologist, I especially appreciated the authors' frequent reference to psychopharmacology as one component of comprehensive pediatric mental health treatment that ultimately should address the child's psychosocial functioning, family involvement, and connections between mental health providers and the child's school.

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