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Book Review

Pharmacotherapy of Child and Adolescent Psychiatric Disorders, 3rd ed

Theodore A. Petti, MD, MPH

Published: July 15, 2012

Pharmacotherapy of Child and Adolescent Psychiatric Disorders, 3rd ed

edited by David R. Rosenberg, MD, and Samuel Gershon, MD. Wiley-Blackwell, West Sussex, United Kingdom, 2012, 453 pages, $100.00 (hardcover).

The past decade has witnessed the coming of age of child and adolescent psychopharmacology and related areas. This edited work elegantly chronicles the core of these achievements in a highly readable and user friendly fashion. Readers will find themselves drawn into an almost seamless narrative that begins with contributions by eminent psychopharmacologists—a brief foreword by Neal Ryan and an introductory chapter with historical perspectives by Sam Gershon. Following this, several chapters on general but critical areas of child and adolescent psychopharmacology provide a seemingly neverending wealth of information that may be a welcome review for those deeply involved in this area and a source of incredible insight for those prescribing psychotropic medications to children and adolescents. These initial chapters focus on pharmacoepidemiology, off-label prescribing, use of generic drugs, and basic concepts in clinical pharmacology as related to psychoactive drug use in children. Each of these chapters is a gem in its own right and a testament to the editors for their grasp of what will be of use to the prescribing clinician; health, mental health, and special education professionals; and anyone interested in gaining understanding of basic issues pertaining to this area.

The bulk of the book focuses on classes of drugs, beginning with psychostimulants and progressing through tricyclic antidepressants and monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, atypical antidepressants, antipsychotic agents, lithium, anticonvulsants, anxiolytics, and then adrenergic agents. Each chapter provides sufficient information about basic properties, the available neuroscience, actions, indications, adverse effects, and the evidence base for their use. Although comprehensive and covering major and relevant studies, the material as presented is neither overwhelming nor likely to induce a soporific state of mind. A "cookie-cutter" template does not appear to have been forced upon the authors, and each medication class chapter reflects what seems most germane and relevant for the individual class or subclass of drugs. Tables are used effectively to encapsulate critical information and make it easily available for future use. Lack of educational material or references to such for parents and children may be the only critical dimension that these highly informative chapters do not address.

The remaining chapters consider the critical areas of atypical psychopharmacologic strategies, preschool children, and combination pharmacotherapy in children and adolescents. Here, too, readers are provided terrific information and understanding regarding innovative approaches, real-world issues we must confront, the extent to which there is an evidence base, and cautions that must be considered.

Several features make this book especially reader friendly. Each chapter is heavily referenced for readers who want to delve deeper into a particular facet or want to know the name of a study or its investigator(s). The table of contents is particularly useful for finding a specific focus, and it serves to illustrate the richness of information within a particular chapter. Of special use for the busy clinician is the listing of the first page for each chapter’s subsections. For example, within the chapter on pharmacoepidemiology, the table of contents lists the following subsections: Introduction, Prevalence and Trends for Medications Prescribed for ADHD, Nonstimulant Medications for ADHD, Antidepressant Medication, Antipsychotic Medication, Alpha-Agonists, Anticonvulsant "Mood Stabilizers," Concomitant Psychotropic Medication, Preschool Psychotropic Medication Use, International Patterns of Psychotropic Medication for Youth, Conclusion, and References. For chapters on specific classes of medication, the subsections listed in the table of contents are generally those topics most useful or germane to understanding, prescribing, and monitoring medications within that class of psychotropics.

Given concerns and controversy over medication treatment for young children, the chapter "Psychopharmacology in Preschool Children" provides a developmental perspective and considers the hierarchy of responses when treating psychiatrically ill very young children with regard to the critical role of psychotherapy and psychosocial interventions prior to initiating psychopharmacology. It does, however, also consider situations when psychopharmacology may be considered as a first line, how to administer and monitor medications for the preschool population, and off-label prescribing. Similar concepts appear in several chapters, but, of importance, they are presented as complementary, not redundant; useful, not pedantic.

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.

Theodore A. Petti, MD, MPH

Author affiliation: Department of Psychiatry, Robert Wood Johnson Medical School-University of Medicine and Dentistry of New Jersey, Piscataway.

Potential conflicts of interest: None reported.

Volume: 73

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