Child and adolescent clinical psychopharmacology

BOOK REVIEW

Child and adolescent clinical psychopharmacology

Felipe Almeida Picon

Psychiatrist, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Child and Adolescent Psychiatry Resident, UFRGS

^{Correspondence}

Wayne Hugo Green

Philadelphia, Lippincott Williams & Wilkins, 2007, 4th edition

Although it is a relatively new medical specialty, child and adolescent psychiatry has been growing fast as an area of important research and therapeutic enhancements. In the field of psychopharmacology, there is much work to be done in terms of randomized and well designed clinical trials attesting the efficacy of many drugs that have only been approved for use in adults. It is in such a fertile field that the book by Professor Wayne Hugo Green, at New York University Child Study Center, brings us closer to more recent uses of psychopharmacology in patients under 18 years of age.

All those providing care to children and adolescents in psychiatry must have been through situations in which drugs were required, or also through other situations in which authorized drugs for this age group were not totally effective. This type of situation is exhaustively approached by Green, as his book always lists off-label uses of drugs approved by the Food and Drug Administration only for certain disorders. In the beginning of the book, the author informs us about the possibility of using clinical sense to prescribe drugs that we deem necessary to our patients, even if there is no strong scientific confirmation for them. At the same time, he believes that, in the future, we may have all indications based on judicious studies and emphasizes the rational use of psychotropics, always taking into account previous studies in adults, for example, when there is a lack of studies in children and adolescents, or the expertise of more experienced colleagues.

This is the fourth edition of this book; the first was published in 1991, the second in 1995, the third in 2001, and the current one in 2007. Green divided the book into two sections. The first deals with the general principles of psychopharmacology in children and adolescents, with its different characteristics of psychotropic use in this population, and the second part focuses on drugs and their specificities. This second part is the longest and is divided into varied classes of drugs. After an introduction about the start of psychopharmacology in this age group, he comments on how critical we should be regarding scientific studies, since what is statistically significant is not necessarily clinically significant. Next, Green deals with each of the following classes: stimulants, typical antipsychotics, atypical antipsychotics, antidepressants, mood stabilizers, antianxiety drugs, and other drugs, such as antihistamines, opiate antagonists, beta blockers, alpha-adrenergic agonists, barbiturates, and hypnotics. The specific sections are divided into introduction, pharmacokinetics, presentations, contraindications, drug interactions, adverse or untoward effects, approved or not approved indications of use, and finally reports of interest. That last part perhaps is the most special part of the book. Green lists studies regarding each drug in detail. He reports and comments on the findings of studies essentially performed in children and adolescents and, when such studies are not available, he provides the evidence in samples of adults.

Child and adolescent clinical psychopharmacology, 4th edition, is undoubtedly an important work in psychopharmacology and is an extremely useful tool for all child and adolescent psychiatrists. Green's essentially clinical approach makes this an everyday book, while his compilation of relevant scientific references makes it more than a manual of quick reference. Green leaves us more prepared to help our young patients whenever some psychotropic drug is necessary.

BOOK REVIEW

Child and adolescent clinical psychopharmacology

Felipe Almeida Picon

Psychiatrist, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Child and Adolescent Psychiatry Resident, UFRGS

^{Correspondence}

Wayne Hugo Green

Philadelphia, Lippincott Williams & Wilkins, 2007, 4th edition

Although it is a relatively new medical specialty, child and adolescent psychiatry has been growing fast as an area of important research and therapeutic enhancements. In the field of psychopharmacology, there is much work to be done in terms of randomized and well designed clinical trials attesting the efficacy of many drugs that have only been approved for use in adults. It is in such a fertile field that the book by Professor Wayne Hugo Green, at New York University Child Study Center, brings us closer to more recent uses of psychopharmacology in patients under 18 years of age.

All those providing care to children and adolescents in psychiatry must have been through situations in which drugs were required, or also through other situations in which authorized drugs for this age group were not totally effective. This type of situation is exhaustively approached by Green, as his book always lists off-label uses of drugs approved by the Food and Drug Administration only for certain disorders. In the beginning of the book, the author informs us about the possibility of using clinical sense to prescribe drugs that we deem necessary to our patients, even if there is no strong scientific confirmation for them. At the same time, he believes that, in the future, we may have all indications based on judicious studies and emphasizes the rational use of psychotropics, always taking into account previous studies in adults, for example, when there is a lack of studies in children and adolescents, or the expertise of more experienced colleagues.

This is the fourth edition of this book; the first was published in 1991, the second in 1995, the third in 2001, and the current one in 2007. Green divided the book into two sections. The first deals with the general principles of psychopharmacology in children and adolescents, with its different characteristics of psychotropic use in this population, and the second part focuses on drugs and their specificities. This second part is the longest and is divided into varied classes of drugs. After an introduction about the start of psychopharmacology in this age group, he comments on how critical we should be regarding scientific studies, since what is statistically significant is not necessarily clinically significant. Next, Green deals with each of the following classes: stimulants, typical antipsychotics, atypical antipsychotics, antidepressants, mood stabilizers, antianxiety drugs, and other drugs, such as antihistamines, opiate antagonists, beta blockers, alpha-adrenergic agonists, barbiturates, and hypnotics. The specific sections are divided into introduction, pharmacokinetics, presentations, contraindications, drug interactions, adverse or untoward effects, approved or not approved indications of use, and finally reports of interest. That last part perhaps is the most special part of the book. Green lists studies regarding each drug in detail. He reports and comments on the findings of studies essentially performed in children and adolescents and, when such studies are not available, he provides the evidence in samples of adults.

Child and adolescent clinical psychopharmacology, 4th edition, is undoubtedly an important work in psychopharmacology and is an extremely useful tool for all child and adolescent psychiatrists. Green's essentially clinical approach makes this an everyday book, while his compilation of relevant scientific references makes it more than a manual of quick reference. Green leaves us more prepared to help our young patients whenever some psychotropic drug is necessary.

Correspondence: [e-mail]

Publication Dates

• Publication in this collection
  01 Dec 2008
• Date of issue
  Apr 2008