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12 and HoldingA Guide to Asperger SyndromeA Lethal InheritanceA Mother's Courage: Talking Back to AutismA Parent's Guide to Asperger Syndrome and High-Functioning AutismA Special EducationA Toss Of The DiceA Tribe ApartA User Guide to the GF/CF Diet for Autism, Asperger Syndrome and AD/HDA Walk in the Rain With a BrainABC of Eating DisordersADD-Friendly Ways to Organize Your LifeADHD Grown UpADHD in the Schools: Assessment and Intervention StrategiesADHD NationAdolescence and Body ImageAdolescent DepressionAggression and Antisocial Behavior in Children and AdolescentsAll Alone in the UniverseAlpha GirlsAmericaAnother PlanetAntisocial Behavior in Children and AdolescentsAsperger Syndrome and Your ChildAsperger Syndrome, Adolescence, and IdentityAsperger's and GirlsAssessment of Childhood DisordersAttention Deficit DisorderAttention-Deficit Hyperactivity DisorderAttention-Deficit/Hyperactivity DisorderAutism - The Eighth Colour of the RainbowAutism and MeAutism's False ProphetsAutistic Spectrum DisordersBad GirlBeen There, Done That? DO THIS!Before I DieBetween Two WorldsBeyond AppearanceBig Mouth & Ugly GirlBipolar ChildrenBipolar Disorder in Childhood and Early AdolescenceBipolar DisordersBipolar KidsBlackwell Handbook of Childhood Cognitive DevelopmentBody Image, Eating Disorders, and ObesityBody Image, Eating Disorders, and Obesity in YouthBoy AloneBrain-Based Therapy with Children and AdolescentsBreaking PointBreathing UnderwaterBringing Up ParentsBullying and TeasingBullying PreventionBut I Love HimCan't Eat, Won't EatCaring for a Child with AutismCatalystChild and Adolescent PsychiatryChild and Adolescent Psychological DisordersChild and Adolescent PsychopathologyChild NeuropsychologyChild Well-BeingChildren and SexualityChildren Changed by TraumaChildren with Emerald EyesChildren with Sexual Behavior ProblemsChildren, Sexuality and SexualizationChildren’s Dreaming and the Development of Consciousness City of OneCommunication Issues In Autism And Asperger SyndromeConcepts of NormalityConcise Guide to Child and Adolescent PsychiatryConquering the Beast WithinConsuming KidsContesting ChildhoodCount Us InCrackedCrossesCutCyber-Safe Kids, Cyber-Savvy TeensDamageDemystifying the Autistic ExperienceDescartes' BabyDilemmas of DesireDirtyDisconnected KidsDoing SchoolDon't Bother Me Mom--I'm Learning!Don't Pick On MeDying to Be ThinEarly Intervention Programs and PoliciesEating an ArtichokeEducating Children With AutismEight Stories UpElijah's CupEmerald City BluesEmotional and Behavioral Problems of Young ChildrenEpilepticEthical Dilemmas in PediatricsEvery Girl Tells a StoryExiting NirvanaExploiting ChildhoodEye ContactFacing BipolarFamily HistoryFast GirlsForever YoungFreaks, Geeks and Asperger SyndromeFreewillFrictionGirl CultureGirl in the MirrorGirlfightingGirlhoodGirlWiseHandbook of Evidence-Based Therapies for Children and AdolescentsHandbook of Preschool Mental HealthHealing ADDHelping Children Cope With Disasters and TerrorismHelping Hyperactive KidsHelping Parents, Youth, and Teachers Understand Medications for Behavioral and Emotional ProblemsHelping Students Overcome Depression and AnxietyHelping Teens Who CutHollow KidsHope's BoyHow Infants Know MindsHow to Keep Your Teenager Out of Trouble and What to Do If You Can'tHurry Down SunshineI Am Not Joey PigzaIdentifying Hyperactive ChildrenIf Your Adolescent Has an Eating DisorderIn the Company of CraziesIncorporating Social Goals in the ClassroomIntegrated YogaIntrusive ParentingIssues for Families, Schools and CommunitiesJake RileyJoey Pigza Loses ControlJoey Pigza Swallowed the KeyJuvenile-Onset SchizophreniaKim: Empty InsideLearning and Behavior Problems in Asperger SyndromeLearning Disorders and Disorders of the Self in Children and AdolescentsLearning Outside the Lines Let Kids Be KidsLiberation's ChildrenLife As We Know ItLisa, Bright and DarkLook Me in the EyeLoserLove and SexLove That DogMad at SchoolMaking ADD WorkMaking American BoysManicMastering Anger and AggressionMaverick MindMedicating ChildrenMind FieldsMind to MindMommy I'm Still in HereMore Than a LabelMy Flesh and BloodMyths of ChildhoodNew Hope for Children and Teens with Bipolar DisorderNew Look at ADHD: Inhibition, Time, and Self-ControlNo Child Left DifferentNo Two AlikeNon-Drug Treatments for ADHDNot Much Just Chillin'NurtureShockOdd Girl OutOdd Girl Speaks OutOne Hot SecondOne in ThirteenOphelia SpeaksOphelia's MomOur Journey Through High Functioning Autism and Asperger SyndromeOut of the WoodsOvercoming ADHDOvercoming School AnxietyParenting a Child Who Has Intense EmotionsParenting Children With ADHDParenting Your Out-Of-Control TeenagerPediatric PsychopharmacologyPediatric PsychopharmacologyPediatric PsychopharmacologyPeople with HyperactivityPhobic and Anxiety Disorders in Children and AdolescentsPINSPlease Don't Label My ChildPraising Boys WellPraising Girls WellProblem Child or Quirky Kid?Problem GirlsPsychotherapy for Children and AdolescentsPsychotherapy with Children and AdolescentsPurgeRaising a Moody ChildRaising BlazeRaising Generation RxRaising Resilient ChildrenReady or Not, Here Life ComesReclaiming Our ChildrenRedressing the EmperorReducing Adolescent RiskRemembering Our ChildhoodResilience in ChildrenRethinking ADHDReweaving the Autistic TapestryRitalin is Not the Answer Action GuideRitalin NationRunning on RitalinRunning with ScissorsRutter's Child and Adolescent PsychiatrySeeing EzraSex and the American TeenagerSex, Therapy, and KidsSexting and Young PeopleSexual Teens, Sexual MediaShort Term 12Should I Medicate My Child?SmashedSnapshots of AutismSongs Without WordsSophie Spikey Has a Very Big ProblemSpeakStaying Connected to Your TeenagerStick FigureStraight Talk about Psychiatric Medications for KidsStraight Talk about Psychological Testing for KidsStraight Talk about Your Child's Mental HealthStrange SonStudent DepressionSuicidal Behavior in Children and AdolescentsSurvival Strategies for Parenting Children with Bipolar DisorderSurviving OpheliaTaking Charge of ADHD, Revised EditionTaming the Troublesome ChildTemple GrandinThe American Psychiatric Publishing Textbook Of Child And Adolescent PsychiatryThe Anti-Romantic ChildThe Bipolar ChildThe Boy Who Loved Too MuchThe Boy Who Loved WindowsThe Boy Who Was Raised as a DogThe Buffalo TreeThe Bully Action GuideThe Bully, the Bullied, and the BystanderThe Burn JournalsThe Color of AbsenceThe Curious Incident of the Dog in the Night-TimeThe Depressed ChildThe Developing MindThe Dragons of AutismThe Einstein SyndromeThe EpidemicThe Evolution of ChildhoodThe Explosive ChildThe Eyes of van GoghThe Fasting GirlThe Field of the DogsThe Flight of a DoveThe Hidden Gifts of the Introverted ChildThe Horse BoyThe Identity TrapThe Inner World of a Suicidal YouthThe Inside Story on Teen GirlsThe Kindness of StrangersThe Last Normal ChildThe Little MonsterThe Medicated ChildThe Myth of LazinessThe New Gay TeenagerThe Nurture AssumptionThe OASIS Guide to Asperger SyndromeThe Other ParentThe Perversion of YouthThe Philosophy of AutismThe Psychoanalytic Study of the ChildThe Real Truth About Teens and SexThe Ride TogetherThe Rise and Fall of the American TeenagerThe Science of ADHDThe Sex Lives of TeenagersThe Survival Guide for Kids With LD*The Unhappy ChildThen Again, Maybe I Won'tTherapy with ChildrenThings I Have to Tell YouThings Tom LikesThrough the Glass WallThumbsuckerTotally WiredTouching Spirit BearTrauma in the Lives of ChildrenTreating ADHD and Comorbid DisordersTreatment of Childhood DisordersTwistedUnder the Wolf, Under the DogUnhappy TeenagersUnstrange MindsWastedWe've Got IssuesWeather Reports from the Autism FrontWhat about the KidsWhat in the World Are Your Kids Doing Online?What Works for Whom?What Would Joey Do?What's Happening to My Body? Book for BoysWhat's Happening to My Body? Book for GirlsWhat's Happening to Tom?When Nothing Matters AnymoreWhen Your Child Has an Eating DisorderWhose America?Why Don't Students Like SchoolWill's ChoiceWinnicott On the ChildWorried All the TimeYou Hear MeYoung Minds in Social WorldsYoung People and Mental HealthYour Child, Bully or Victim?
A large body of research literature
exists on the topic of treatments for adults with psychiatric disorders.
Although this research does not always provide clear-cut answers to clinical
questions, by and large one can find a published study or opinion on most
topics and questions within adult psychiatry.
In the field of child psychiatry
the scene is quite different. There are far fewer child psychiatrists overall,
and child psychiatric researchers in particular, than there are adult
psychiatrists and researchers. In adult psychiatry there are at least four
major monthly journals devoted to publishing significant research findings; in
child psychiatry there is one. Many basic questions pertaining to the
psychiatric treatment of children and adolescents remain unanswered, or even
Thus, the editors of Pediatric
Psychopharmacology faced a considerable challenge in assembling a
compendium of the accumulated knowledge pertaining to the psychopharmacological
treatment of children and adolescents. Three of the editors are on the faculty
of the Yale Child Study Center, while the fourth is a senior scientist at the
National Institute of Mental Health (NIMH). The volume is dedicated to the
memory of Donald J. Cohen, the late chairman of child psychiatry at Yale, who
was a major force behind the ascension of the neurobiological perspective in
child psychiatry over the past three decades.
The volume is divided into for
major sections: an introductory section on the neurobiological underpinnings of
current understanding of both mental illness and drug effects in the central
nervous system; a lengthy section on the classes of medications and other "somatic"
interventions most commonly used in child psychiatry; a section on issues and
recommendations in assessment and treatment of childhood mental disorders; and
a concluding section on issues in research, ethics, and epidemiology that
confront contemporary child psychiatrists. More than one hundred authors
contribute to the volume's 56 chapters, and the table of contents contains a
virtual Who's Who of American and international academic child psychiatry.
Most of the authors are the preeminent authorities on their subject matter--again
a reflection of the relatively small community that constitutes academic child
A formal review of child
psychopharmacology forms only one quarter of the volume, and one wonders if a
more descriptive title would have been The Biological Basis of Child
Psychiatry. The book aspires to address nearly every aspect of child
psychiatric practice, covering aspects of the topic well beyond the realm of
medications and their use. The breadth and depth of coverage is quite
remarkable, ranging from musings on the influence of pharmaceutical companies
in a chapter on prescribing practices, to detailed description of the anatomy
of the bladder in a chapter on enuresis, to detailed and highly technical
descriptions of neuronal migration in the forebrain in a chapter on
neurological development. Detail about each of the medications in the child psychiatrists'
armamentarium is extensive without becoming overwhelming. The authors do a
good job of highlighting controversies and pitfalls in the field, such as the
reported association between valproic acid and polycystic ovary syndrome. At a
hefty 791 pages, the book appears better suited for use as a reference text to
be consulted selectively rather than an overview to be read cover-to-cover in a
few sittings. Additionally, the book appears to be aimed squarely at
psychiatrists and associated faculty in academic settings, as few clinicians in
private practice will likely appreciate the extensive content on non-clinical,
basic science aspects of psychopharmacology.
A particularly valuable and
unexpected feature of the book is the inclusion of more "philosophical"
chapters, which consider the context and larger meanings of psychiatric
medications for children. In chapters with titles such as "Psychopharmacological
Treatment of Preschoolers," "Thinking About Prescribing," "Who
Is Prescribing? And for Whom, How, and Why?," the authors take a step back
from the raw data of clinical trials and pharmacokinetic studies to consider
what the use of psychotropic medications implies about child psychiatrists, the
parents and children who seek treatment, and the role of medications in
As with all medical textbooks,
there is a significant lag time between submission of the manuscript and
appearance of the work in print. Most of the research papers cited were
published during or before 2001, which is an impressive feat for a book
published in 2003. However, some important issues that have emerged since
2001, including the FDA's recent precautions regarding SSRI's in children, and
the withdrawal of nefazodone from European markets, are not addressed in this
volume. The citations and bibliographies at the end of each chapter are
extensive and up-to-date. An increasingly common practice in psychiatry texts
is for the most important two or three references to be marked with an
asterisk, and this would have improved the utility of the reference lists.
In summary, then, Pediatric
Psychopharmacology provides a well-written and nearly comprehensive guide
to the biology of mental illness in children and adolescents.
The editors manage to survey the
broad and sometimes contradictory corpus of literature in the field and to
organize current knowledge in a reader-friendly format and sequence. The
authors for the most part write in crisp and engaging prose. One wishes that
they could make more conclusive statements about clinical decision-making, but
the relative paucity of research in the field preclude definitive treatment
strategies for many conditions. Nevertheless, the book is likely to become a
landmark in the field and to set a new standard for research-driven
publications in child psychiatry.
© 2004 Michael
Brodsky is a psychiatrist in training in Los
Angeles, California, and an avid reader.