David Rosenberg MD, Miriam L. Hamburger Endowed Chair of Child Psychiatry and Professor & Chief of Child Psychiatry and Psychology at Wayne State University and the Children's Hospital of Michigan, Detroit, MI , USA Samuel Gershon MD, Emeritus Professor of Psychiatry, University of Pittsburgh, PA, USA

• List of Contributors, xv Foreword, xixChapter 1 Historical Perspectives on Child and Adolescent Psychopharmacology, 1Samuel GershonReferences, 4Chapter 2 Pharmacoepidemiology of Psychotropic Medications in Youth, 7Daniel J. Safer & Julie Magno ZitoIntroduction, 7Prevalence and trends for medications prescribed for ADHD, 8Nonstimulant medications for ADHD, 11Antidepressant medication, 11Antipsychotic medication, 13Alpha-agonists, 14Anticonvulsant "mood stabilizers", 15Concomitant psychotropic medication, 15Preschool psychotropic medication use, 17International patterns of psychotropic medication for youth, 17Conclusion, 18References, 18Chapter 3 Off-Label Prescribing of Drugs in Child and Adolescent Psychiatry, 25C. Lindsay DeVaneIntroduction, 25Extent of off-label prescribing, 27Need for psychoactive drug treatments for children and adolescents, 31Legislation supporting pediatric drug development, 33Recommendations to follow when considering off-label prescribing, 35References, 36Chapter 4 The Use of Generic Drugs in Pediatric Psychopharmacology, 39Richard I. Shader & Christopher-Paul MilneWhat is a generic drug?, 39Why are we discussing generic drugs?, 39Basic requirements for generic drugs, 40The status of regulations regarding generic drugs and children, 41Abbreviated new drug application (ANDA) requirements, 42Pediatric assessments of adult drugs (history up to current status), 43Best Pharmaceuticals for Children Act, 44Pediatric Research Equity Act, 45Intersection of requirements for generics and pediatric assessment, 46Future directions, 48Concluding thoughts, 49References, 49Chapter 5 Psychoactive Drug Use in Children: Basic Concepts in Clinical Pharmacology, 51David J. EdwardsIntroduction, 51Basic concepts in pharmacokinetics, 52Dosing considerations for psychoactive drugs in children, 55Summary, 60References, 60Chapter 6 Psychostimulants, 65Steven R. PliszkaIntroduction, 65Epidemiology of stimulant use, 66Structure and biochemical mechanism of action, 66Neuroimaging studies of stimulant effects, 67Studies of short-term efficacy, 72Studies of long-term efficacy, 76Clinical use, 79Common side-effects, 84Cardiovascular safety issues, 86Growth suppression, 88Substance use and diversion, 88Comparison with nonstimulant treatment, 89Treatment of comorbidity, 92Pharmacogenetics, 93Conclusions, 94References, 94Chapter 7 Tricyclic Antidepressants and Monoamine Oxidase Inhibitors for the Treatment of Child and Adolescent Psychiatric Disorders, 105Charlotte M. Heleniak, Tejal Kaur, Kareem D. Ghalib & Moira A. RynnTricyclic antidepressants (TCAs), 105Drug interactions, contraindications, 116Monoamine oxidase inhibitors (MAOIs), 117General summary, 122References, 123Chapter 8 Selective Serotonin Reuptake Inhibitors (SSRIs), 131Dara Sakolsky & Boris BirmaherPharmacokinetics, 131Initiation and titration, 133Indications and efficacy, 134Adverse effects, 146Withdrawal, 149References, 149Chapter 9 Novel (Atypical) Antidepressants, 155Heidi R. Bruty, Graham J. Emslie & Paul CroarkinNovel (atypical) antidepressants, 155General overview, 155Bupropion, 157Duloxetine, 162Mirtazapine, 164Trazodone, 166Venlafaxine, 170Desvenlafaxine, 173Alternative treatments, 174Summary, 175References, 176Chapter 10 Antipsychotic Agents, 181Brieana M. Rowles, John L. Hertzer & Robert L. FindlingIntroduction, 181Chemical properties, 182Typical antipsychotics, 183Atypical antipsychotics, 186Ethical issues: treatment of at-risk populations, 212Conclusions, 213References, 213Chapter 11 Lithium, 221Garrett M. Sparks & David A. AxelsonIntroduction, 221Pharmacology, 222Potential mechanisms of action, 222Evidence for the use of lithium in children and adolescents, 232Dosing and drug monitoring, 239Contraindications, precautions, and drug interactions, 242Side-effects, 246References, 250Chapter 12 Anticonvulsants Used in Child and Adolescent Psychiatric Disorders, 261Mani Pavuluri & Tushita Mayanil Introduction, 261Divalproex sodium, 261Carbamazepine, 271Oxcarbazepine, 275Lamotrigine, 279Gabapentin, 284Topiramate, 285Conclusion, 288References, 288Chapter 13 Anxiolytics, 301Barbara J. Coffey & Amanda L. ZwillingChemical properties, 301Indications, 305Contraindications, 320Adverse effects, 321Overdose, 324Abuse/dependence, 324Drug interactions, 325Available preparations and cost, 325Initiation and maintenance of treatment, 325Management of specific side-effects, 330How to withdraw medication, 332References, 332Chapter 14 Adrenergic Agents in Child and Adolescent Psychiatry, 341Lawrence David ScahillClonidine and guanfacine, 341Guanfacine, 349Beta-blockers, 355Acknowledgements, 361References, 361Chapter 15 Atypical Psychopharmacologic Strategies, 365Jess Shatkin & Aron JanssenOpiate antagonists, 365Memantine, 368Riluzole, 369Secretin, 371Topiramate, 372Herbal medications and dietary supplements, 373Ginkgo (Ginkgo biloba), 375Melatonin, 381Omega-3 fatty acids, 383St. John's wort (Hypericum perforatum), 384Valerian (Valeriana officinalis), 387Conclusion, 388References, 389Chapter 16 Psychopharmacology in Preschool Children, 399Mini Tandon & Joan LubyIntroduction, 399Developmental considerations, 400Rise in psychopharmacology use, 402Psychotherapy before psychopharmacology, 403When psychopharmacology may be considered as a first line: pragmatic considerations, 404Psychopharmacology in preschool disorders: administration and monitoring, 404Off-label prescribing: special considerations, 407Use of psychotropics in specific disorders, 408Summary, 415References, 415Chapter 17 Combination Pharmacotherapy for Psychiatric Disorders in Children and Adolescents, 421Gagan Joshi & Anna M. GeorgiopoulosBipolar disorder, 422Major depressive disorder, 429Attention-deficit hyperactivity disorder, 431Obsessive-compulsive disorder, 433Tics and Tourette's syndrome, 434Pervasive developmental disorders, 434Conclusion, 434References, 435Index, 439

“Pharmacotherapy of Child and Adolescent Psychiatric Disorders is a book to have available on your desk, not just in your library.  It provides ready access to the wealth of practical information and insight for the range of health and mental health professionals.  It is highly recommended for trainees and anyone who is prescribing psychotropic medications to the pediatric population and young adults.”  (Journal of Clinical Psychiatry, 7 July 2012)

David Rosenberg MD, Miriam L. Hamburger Endowed Chair of Child Psychiatry and Professor & Chief of Child Psychiatry and Psychology at Wayne State University and the Children's Hospital of Michigan, Detroit, MI , USA Samuel Gershon MD, Emeritus Professor of Psychiatry, University of Pittsburgh, PA, USA

• List of Contributors, xv Foreword, xixChapter 1 Historical Perspectives on Child and Adolescent Psychopharmacology, 1Samuel GershonReferences, 4Chapter 2 Pharmacoepidemiology of Psychotropic Medications in Youth, 7Daniel J. Safer & Julie Magno ZitoIntroduction, 7Prevalence and trends for medications prescribed for ADHD, 8Nonstimulant medications for ADHD, 11Antidepressant medication, 11Antipsychotic medication, 13Alpha-agonists, 14Anticonvulsant "mood stabilizers", 15Concomitant psychotropic medication, 15Preschool psychotropic medication use, 17International patterns of psychotropic medication for youth, 17Conclusion, 18References, 18Chapter 3 Off-Label Prescribing of Drugs in Child and Adolescent Psychiatry, 25C. Lindsay DeVaneIntroduction, 25Extent of off-label prescribing, 27Need for psychoactive drug treatments for children and adolescents, 31Legislation supporting pediatric drug development, 33Recommendations to follow when considering off-label prescribing, 35References, 36Chapter 4 The Use of Generic Drugs in Pediatric Psychopharmacology, 39Richard I. Shader & Christopher-Paul MilneWhat is a generic drug?, 39Why are we discussing generic drugs?, 39Basic requirements for generic drugs, 40The status of regulations regarding generic drugs and children, 41Abbreviated new drug application (ANDA) requirements, 42Pediatric assessments of adult drugs (history up to current status), 43Best Pharmaceuticals for Children Act, 44Pediatric Research Equity Act, 45Intersection of requirements for generics and pediatric assessment, 46Future directions, 48Concluding thoughts, 49References, 49Chapter 5 Psychoactive Drug Use in Children: Basic Concepts in Clinical Pharmacology, 51David J. EdwardsIntroduction, 51Basic concepts in pharmacokinetics, 52Dosing considerations for psychoactive drugs in children, 55Summary, 60References, 60Chapter 6 Psychostimulants, 65Steven R. PliszkaIntroduction, 65Epidemiology of stimulant use, 66Structure and biochemical mechanism of action, 66Neuroimaging studies of stimulant effects, 67Studies of short-term efficacy, 72Studies of long-term efficacy, 76Clinical use, 79Common side-effects, 84Cardiovascular safety issues, 86Growth suppression, 88Substance use and diversion, 88Comparison with nonstimulant treatment, 89Treatment of comorbidity, 92Pharmacogenetics, 93Conclusions, 94References, 94Chapter 7 Tricyclic Antidepressants and Monoamine Oxidase Inhibitors for the Treatment of Child and Adolescent Psychiatric Disorders, 105Charlotte M. Heleniak, Tejal Kaur, Kareem D. Ghalib & Moira A. RynnTricyclic antidepressants (TCAs), 105Drug interactions, contraindications, 116Monoamine oxidase inhibitors (MAOIs), 117General summary, 122References, 123Chapter 8 Selective Serotonin Reuptake Inhibitors (SSRIs), 131Dara Sakolsky & Boris BirmaherPharmacokinetics, 131Initiation and titration, 133Indications and efficacy, 134Adverse effects, 146Withdrawal, 149References, 149Chapter 9 Novel (Atypical) Antidepressants, 155Heidi R. Bruty, Graham J. Emslie & Paul CroarkinNovel (atypical) antidepressants, 155General overview, 155Bupropion, 157Duloxetine, 162Mirtazapine, 164Trazodone, 166Venlafaxine, 170Desvenlafaxine, 173Alternative treatments, 174Summary, 175References, 176Chapter 10 Antipsychotic Agents, 181Brieana M. Rowles, John L. Hertzer & Robert L. FindlingIntroduction, 181Chemical properties, 182Typical antipsychotics, 183Atypical antipsychotics, 186Ethical issues: treatment of at-risk populations, 212Conclusions, 213References, 213Chapter 11 Lithium, 221Garrett M. Sparks & David A. AxelsonIntroduction, 221Pharmacology, 222Potential mechanisms of action, 222Evidence for the use of lithium in children and adolescents, 232Dosing and drug monitoring, 239Contraindications, precautions, and drug interactions, 242Side-effects, 246References, 250Chapter 12 Anticonvulsants Used in Child and Adolescent Psychiatric Disorders, 261Mani Pavuluri & Tushita Mayanil Introduction, 261Divalproex sodium, 261Carbamazepine, 271Oxcarbazepine, 275Lamotrigine, 279Gabapentin, 284Topiramate, 285Conclusion, 288References, 288Chapter 13 Anxiolytics, 301Barbara J. Coffey & Amanda L. ZwillingChemical properties, 301Indications, 305Contraindications, 320Adverse effects, 321Overdose, 324Abuse/dependence, 324Drug interactions, 325Available preparations and cost, 325Initiation and maintenance of treatment, 325Management of specific side-effects, 330How to withdraw medication, 332References, 332Chapter 14 Adrenergic Agents in Child and Adolescent Psychiatry, 341Lawrence David ScahillClonidine and guanfacine, 341Guanfacine, 349Beta-blockers, 355Acknowledgements, 361References, 361Chapter 15 Atypical Psychopharmacologic Strategies, 365Jess Shatkin & Aron JanssenOpiate antagonists, 365Memantine, 368Riluzole, 369Secretin, 371Topiramate, 372Herbal medications and dietary supplements, 373Ginkgo (Ginkgo biloba), 375Melatonin, 381Omega-3 fatty acids, 383St. John's wort (Hypericum perforatum), 384Valerian (Valeriana officinalis), 387Conclusion, 388References, 389Chapter 16 Psychopharmacology in Preschool Children, 399Mini Tandon & Joan LubyIntroduction, 399Developmental considerations, 400Rise in psychopharmacology use, 402Psychotherapy before psychopharmacology, 403When psychopharmacology may be considered as a first line: pragmatic considerations, 404Psychopharmacology in preschool disorders: administration and monitoring, 404Off-label prescribing: special considerations, 407Use of psychotropics in specific disorders, 408Summary, 415References, 415Chapter 17 Combination Pharmacotherapy for Psychiatric Disorders in Children and Adolescents, 421Gagan Joshi & Anna M. GeorgiopoulosBipolar disorder, 422Major depressive disorder, 429Attention-deficit hyperactivity disorder, 431Obsessive-compulsive disorder, 433Tics and Tourette's syndrome, 434Pervasive developmental disorders, 434Conclusion, 434References, 435Index, 439

“Pharmacotherapy of Child and Adolescent Psychiatric Disorders is a book to have available on your desk, not just in your library.  It provides ready access to the wealth of practical information and insight for the range of health and mental health professionals.  It is highly recommended for trainees and anyone who is prescribing psychotropic medications to the pediatric population and young adults.”  (Journal of Clinical Psychiatry, 7 July 2012)

David Rosenberg MD, Miriam L. Hamburger Endowed Chair of Child Psychiatry and Professor & Chief of Child Psychiatry and Psychology at Wayne State University and the Children's Hospital of Michigan, Detroit, MI , USA Samuel Gershon MD, Emeritus Professor of Psychiatry, University of Pittsburgh, PA, USA

• List of Contributors, xv Foreword, xixChapter 1 Historical Perspectives on Child and Adolescent Psychopharmacology, 1Samuel GershonReferences, 4Chapter 2 Pharmacoepidemiology of Psychotropic Medications in Youth, 7Daniel J. Safer & Julie Magno ZitoIntroduction, 7Prevalence and trends for medications prescribed for ADHD, 8Nonstimulant medications for ADHD, 11Antidepressant medication, 11Antipsychotic medication, 13Alpha-agonists, 14Anticonvulsant "mood stabilizers", 15Concomitant psychotropic medication, 15Preschool psychotropic medication use, 17International patterns of psychotropic medication for youth, 17Conclusion, 18References, 18Chapter 3 Off-Label Prescribing of Drugs in Child and Adolescent Psychiatry, 25C. Lindsay DeVaneIntroduction, 25Extent of off-label prescribing, 27Need for psychoactive drug treatments for children and adolescents, 31Legislation supporting pediatric drug development, 33Recommendations to follow when considering off-label prescribing, 35References, 36Chapter 4 The Use of Generic Drugs in Pediatric Psychopharmacology, 39Richard I. Shader & Christopher-Paul MilneWhat is a generic drug?, 39Why are we discussing generic drugs?, 39Basic requirements for generic drugs, 40The status of regulations regarding generic drugs and children, 41Abbreviated new drug application (ANDA) requirements, 42Pediatric assessments of adult drugs (history up to current status), 43Best Pharmaceuticals for Children Act, 44Pediatric Research Equity Act, 45Intersection of requirements for generics and pediatric assessment, 46Future directions, 48Concluding thoughts, 49References, 49Chapter 5 Psychoactive Drug Use in Children: Basic Concepts in Clinical Pharmacology, 51David J. EdwardsIntroduction, 51Basic concepts in pharmacokinetics, 52Dosing considerations for psychoactive drugs in children, 55Summary, 60References, 60Chapter 6 Psychostimulants, 65Steven R. PliszkaIntroduction, 65Epidemiology of stimulant use, 66Structure and biochemical mechanism of action, 66Neuroimaging studies of stimulant effects, 67Studies of short-term efficacy, 72Studies of long-term efficacy, 76Clinical use, 79Common side-effects, 84Cardiovascular safety issues, 86Growth suppression, 88Substance use and diversion, 88Comparison with nonstimulant treatment, 89Treatment of comorbidity, 92Pharmacogenetics, 93Conclusions, 94References, 94Chapter 7 Tricyclic Antidepressants and Monoamine Oxidase Inhibitors for the Treatment of Child and Adolescent Psychiatric Disorders, 105Charlotte M. Heleniak, Tejal Kaur, Kareem D. Ghalib & Moira A. RynnTricyclic antidepressants (TCAs), 105Drug interactions, contraindications, 116Monoamine oxidase inhibitors (MAOIs), 117General summary, 122References, 123Chapter 8 Selective Serotonin Reuptake Inhibitors (SSRIs), 131Dara Sakolsky & Boris BirmaherPharmacokinetics, 131Initiation and titration, 133Indications and efficacy, 134Adverse effects, 146Withdrawal, 149References, 149Chapter 9 Novel (Atypical) Antidepressants, 155Heidi R. Bruty, Graham J. Emslie & Paul CroarkinNovel (atypical) antidepressants, 155General overview, 155Bupropion, 157Duloxetine, 162Mirtazapine, 164Trazodone, 166Venlafaxine, 170Desvenlafaxine, 173Alternative treatments, 174Summary, 175References, 176Chapter 10 Antipsychotic Agents, 181Brieana M. Rowles, John L. Hertzer & Robert L. FindlingIntroduction, 181Chemical properties, 182Typical antipsychotics, 183Atypical antipsychotics, 186Ethical issues: treatment of at-risk populations, 212Conclusions, 213References, 213Chapter 11 Lithium, 221Garrett M. Sparks & David A. AxelsonIntroduction, 221Pharmacology, 222Potential mechanisms of action, 222Evidence for the use of lithium in children and adolescents, 232Dosing and drug monitoring, 239Contraindications, precautions, and drug interactions, 242Side-effects, 246References, 250Chapter 12 Anticonvulsants Used in Child and Adolescent Psychiatric Disorders, 261Mani Pavuluri & Tushita Mayanil Introduction, 261Divalproex sodium, 261Carbamazepine, 271Oxcarbazepine, 275Lamotrigine, 279Gabapentin, 284Topiramate, 285Conclusion, 288References, 288Chapter 13 Anxiolytics, 301Barbara J. Coffey & Amanda L. ZwillingChemical properties, 301Indications, 305Contraindications, 320Adverse effects, 321Overdose, 324Abuse/dependence, 324Drug interactions, 325Available preparations and cost, 325Initiation and maintenance of treatment, 325Management of specific side-effects, 330How to withdraw medication, 332References, 332Chapter 14 Adrenergic Agents in Child and Adolescent Psychiatry, 341Lawrence David ScahillClonidine and guanfacine, 341Guanfacine, 349Beta-blockers, 355Acknowledgements, 361References, 361Chapter 15 Atypical Psychopharmacologic Strategies, 365Jess Shatkin & Aron JanssenOpiate antagonists, 365Memantine, 368Riluzole, 369Secretin, 371Topiramate, 372Herbal medications and dietary supplements, 373Ginkgo (Ginkgo biloba), 375Melatonin, 381Omega-3 fatty acids, 383St. John's wort (Hypericum perforatum), 384Valerian (Valeriana officinalis), 387Conclusion, 388References, 389Chapter 16 Psychopharmacology in Preschool Children, 399Mini Tandon & Joan LubyIntroduction, 399Developmental considerations, 400Rise in psychopharmacology use, 402Psychotherapy before psychopharmacology, 403When psychopharmacology may be considered as a first line: pragmatic considerations, 404Psychopharmacology in preschool disorders: administration and monitoring, 404Off-label prescribing: special considerations, 407Use of psychotropics in specific disorders, 408Summary, 415References, 415Chapter 17 Combination Pharmacotherapy for Psychiatric Disorders in Children and Adolescents, 421Gagan Joshi & Anna M. GeorgiopoulosBipolar disorder, 422Major depressive disorder, 429Attention-deficit hyperactivity disorder, 431Obsessive-compulsive disorder, 433Tics and Tourette's syndrome, 434Pervasive developmental disorders, 434Conclusion, 434References, 435Index, 439

“Pharmacotherapy of Child and Adolescent Psychiatric Disorders is a book to have available on your desk, not just in your library.  It provides ready access to the wealth of practical information and insight for the range of health and mental health professionals.  It is highly recommended for trainees and anyone who is prescribing psychotropic medications to the pediatric population and young adults.”  (Journal of Clinical Psychiatry, 7 July 2012)