ATYPICAL ANTIPSYCHOTICS IN PEDIATRIC PSYCHIATRY: EFFICACY IN WELL-DESIGNED TRIALS

Christopher J. McDougle, M.D., 541 Clinical Drive, Room 299, Indianapolis, IN 46202

A number of double-blind, placebo-controlled studies of atypical antipsychotics have been conducted in children and adolescents with various neuropsychiatric disorders. These include investigations of clozapine (childhood-onset schizophrenia), risperidone (conduct disorder with and without comorbid mental retardation, autistic disorder) and ziprasidone (Tourette’s disorder). Open-label studies of these and other agents have also been published, including risperidone (childhood-onset schizophrenia, other pervasive developmental disorders, Tourette’s disorder, attention deficit/hyperactivity disorder, bipolar disorder), olanzapine (childhood-onset schizophrenia, autistic disorder, Tourette’s disorder, bipolar disorder) and quetiapine (autistic disorder, psychotic disorders). In general, these studies have found the atypical antipsychotics to be efficacious for the treatment of a number of these disorders, with generally good tolerability. Additional controlled trials are necessary to replicate and extend the results of these preliminary findings. Atypical antipsychotics will likely play a significant role in the treatment of psychotic and nonpsychotic disorders in children and adolescents for a number of years to come. Determination of short- and long-term safety data will be essential.