TY - JOUR
T1 - Unmet needs in paediatric psychopharmacology
T2 - Present scenario and future perspectives
AU - Persico, Antonio M.
AU - Arango, Celso
AU - Buitelaar, Jan K.
AU - Correll, Christoph U.
AU - Glennon, Jeffrey C.
AU - Hoekstra, Pieter J.
AU - Moreno, Carmen
AU - Vitiello, Benedetto
AU - Vorstman, Jacob
AU - Zuddas, Alessandro
AU - European Child & Adolescent Clinic
PY - 2015/10
Y1 - 2015/10
N2 - Paediatric psychopharmacology holds great promise in two equally important areas of enormous biomedical and social impact, namely the treatment of behavioural abnormalities in children and adolescents, and the prevention of psychiatric disorders with adolescent- or adult-onset. Yet, in striking contrast, pharmacological treatment options presently available in child and adolescent psychiatry are dramatically limited. The most important currently unmet needs in paediatric psychopharmacology are: the frequent off-label prescription of medications to children and adolescents based exclusively on data from randomized controlled studies involving adult patients; the frequent lack of age-specific dose, long-term efficacy and tolerability/safety data; the lack of effective medications for many paediatric psychiatric disorders, most critically autism spectrum disorder; the scarcity and limitations of randomized placebo-controlled trials in paediatric psychopharmacology; the unexplored potential for the prevention of psychiatric disorders with adolescent- and adult-onset; the current lack of biomarkers to predict treatment response and severe adverse effects; the need for better preclinical data to foster the successful development of novel drug therapies; and the effective dissemination of evidence-based treatments to the general public, to better inform patients and families of the benefits and risks of pharmacological interventions during development. Priorities and strategies are proposed to overcome some of these limitations, including the European Child and Adolescent Clinical Psychopharmacology Network, as an overarching PanEuropean infrastructure aimed at reliably carrying out much needed psychopharmacological trials in children and adolescents, in order to fill the identified gaps and improve overall outcomes. (C) 2015 Elsevier B.V. and ECNP. All rights reserved.
AB - Paediatric psychopharmacology holds great promise in two equally important areas of enormous biomedical and social impact, namely the treatment of behavioural abnormalities in children and adolescents, and the prevention of psychiatric disorders with adolescent- or adult-onset. Yet, in striking contrast, pharmacological treatment options presently available in child and adolescent psychiatry are dramatically limited. The most important currently unmet needs in paediatric psychopharmacology are: the frequent off-label prescription of medications to children and adolescents based exclusively on data from randomized controlled studies involving adult patients; the frequent lack of age-specific dose, long-term efficacy and tolerability/safety data; the lack of effective medications for many paediatric psychiatric disorders, most critically autism spectrum disorder; the scarcity and limitations of randomized placebo-controlled trials in paediatric psychopharmacology; the unexplored potential for the prevention of psychiatric disorders with adolescent- and adult-onset; the current lack of biomarkers to predict treatment response and severe adverse effects; the need for better preclinical data to foster the successful development of novel drug therapies; and the effective dissemination of evidence-based treatments to the general public, to better inform patients and families of the benefits and risks of pharmacological interventions during development. Priorities and strategies are proposed to overcome some of these limitations, including the European Child and Adolescent Clinical Psychopharmacology Network, as an overarching PanEuropean infrastructure aimed at reliably carrying out much needed psychopharmacological trials in children and adolescents, in order to fill the identified gaps and improve overall outcomes. (C) 2015 Elsevier B.V. and ECNP. All rights reserved.
KW - Autism spectrum disorder
KW - Biomarkers
KW - Intellectual disability
KW - Off-label use
KW - Pharmaceutical policies
KW - Psychopharmacology
KW - AUTISM SPECTRUM DISORDER
KW - ATTENTION-DEFICIT/HYPERACTIVITY DISORDER
KW - DEFICIT-HYPERACTIVITY DISORDER
KW - RANDOMIZED CONTROLLED-TRIALS
KW - FRAGILE-X-SYNDROME
KW - SEROTONIN REUPTAKE INHIBITORS
KW - MAJOR DEPRESSIVE DISORDER
KW - PERVASIVE DEVELOPMENTAL DISORDERS
KW - PLURIPOTENT STEM-CELLS
KW - DOUBLE-BLIND EFFICACY
U2 - 10.1016/j.euroneuro.2015.06.009
DO - 10.1016/j.euroneuro.2015.06.009
M3 - Review article
SN - 0924-977X
VL - 25
SP - 1513
EP - 1531
JO - European Neuropsychopharmacology
JF - European Neuropsychopharmacology
IS - 10
ER -