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Pediatric PsychopharmacologyReview - Pediatric Psychopharmacology
Fast Facts
by Daniel F. Connor and Bruce M. Meltzer
W. W. Norton, 2006
Review by Ben Lovett
Apr 17th 2007 (Volume 11, Issue 16)

Anyone who works with children in the 21st century deals with psychiatric drugs. Teachers observe the effects of Ritalin and Adderall on their students' disruptive behavior, while parents look for signs of improvement in their depressed sons and daughters taking Prozac and Paxil. Pediatricians and family physicians are called on for these drugs more commonly than the child psychiatrists who are so scarce in many areas, and counselors and psychologists often weigh in with their own advice about which drug they've seen the best results with.

Connor & Meltzer's Pediatric Psychopharmacology: Fast Facts supplements such anecdotal evidence with research-based facts distilled from hundreds of studies concerning the effects of psychiatric drugs in children and adolescents, as well as many more studies conducted with adults. The writing is crisp and clear, the research is up to date, and perhaps most importantly, the information is easy to find quickly. The authors state in their preface that they wrote the book as a reference work rather than as a text to be read straight through, and this aim has been well fulfilled.

The book opens with three introductory chapters on pharmacology and special issues in pediatric pharmacology. Although some of this information (e.g., the basics of drug metabolism) will be a review for medically trained readers, all readers will appreciate how concisely the information is presented. Moreover, the chapter on "general principles of treatment" covers topics not always taught to prescribing physicians, such as how to use behavior rating scales to assess and monitor psychiatric symptoms before, during, and after a trial of medication.

The next section of the book contains 10 chapters, one on each class of drugs (e.g., antidepressants, antipsychotics, etc.). For each drug, the book provides information on the mechanism by which the drug works (e.g., which brain chemicals the drug affects), indications and contraindications (times when the drug should or should not be prescribed), guidelines for determining dosage, side effect profiles, and potential interactions with other drugs. Often, there are tables that list each relevant study of the drug, along with how many research participants improved on the drug. Perhaps surprisingly, there are chapters on "alternative medications" (e.g., herbal medications such as St. John's Wort) and electroconvulsive therapy (an electric shock procedure used in certain cases of very severe and treatment-resistant mental illness). For a medical reference work, the writing is relatively free in jargon, and this is consistent with Connor & Meltzer's stated desire that the book be "accessible to the clinician and layperson alike." One unfortunate exception to the book's general accessibility is that trade names for the medications are listed in only one table somewhere in each chapter (and not even in the index), requiring users to look up drugs by their generic or chemical name.

A third section of the book consists of 12 chapters, each one covering a disorder (e.g., ADHD) or class of disorders (e.g., mood disorders). It is here that the book shows its great usefulness for physicians and others (e.g., nurse practitioners) making prescription decisions. Each chapter contains general information about each disorder (diagnostic criteria, prevalence, general treatment strategies other than medication) before presenting guidelines for drug treatment. Especially helpful are chapters on disorders not typically associated with drug treatment: conduct problems, eating disorders, and pervasive developmental disorders (e.g., autism). As in the previous section of the book, tables are often used here to summarize individual studies, again giving the reader a sense of the research base being used to make recommendations.

Five appendices and a bibliography round out the book, and these sections are just as important as the earlier ones. One of the appendices contains over 70 pages of forms to be used in diagnosing disorders, assessing medication effects and side effects, and tracking patient progress over time. Other appendices summarize the drug efficacy literature, review the effects of psychiatric drugs on the cardiovascular system, and list professional organizations and support groups for those interested. Finally, the bibliography cites all of the relevant books and articles referenced in the main text, as well as other general resources in each area. It is these features that distinguish the book from so many other "quick facts" references for physicians.

In sum, Pediatric Psychopharmacology does just what it set out to do; it provides an accessible reference for those interested in the effects of psychiatric medications on children and adolescents with behavioral and emotional problems. It will be most helpful for those professionals who either prescribe psychiatric medications (e.g., pediatricians) or work with children who take the medications (e.g., psychologists) and must understand their effects. However, parents and other interested people can also certainly read the book with profit.

 

© 2007 Ben Lovett

 

Ben Lovett is currently a doctoral candidate in the psychology department at Syracuse University, where his research interests include learning disabilities and ADHD.


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