Preprint
Review

Antipsychotics in the Management of Disruptive Behavior Disorders in Children and Adolescents: An Update and Critical Review

Altmetrics

Downloads

144

Views

46

Comments

0

A peer-reviewed article of this preprint also exists.

This version is not peer-reviewed

Submitted:

21 October 2022

Posted:

21 October 2022

You are already at the latest version

Alerts
Abstract
Disruptive behaviour disorders (DBDs) in childhood, such as conduct disorder (CD) and oppositional defiant disorder (ODD) are characterized by high levels of irritability and aggression. Though psychological management is considered the first-line approach for these disorders, many children and adolescents require adjunctive pharmacotherapy for the control of specific symptoms. Several prior systematic reviews have examined the evidence for the use of antipsychotics in the symptomatic management of DBDs, but have concluded that their efficacy is marginal and limited by significant adverse effects. This paper updates existing reviews of this field by reviewing clinical trials of antipsychotics in children and adolescents with DBDs published in the period 2-1-2017 to 2-10-2022. The PubMed, Scopus and ScienceDirect databases were searched for relevant citations. Six relevant trials were identified during this period. These trials were critically evaluated in terms of outcome measures, efficacy and safety. Overall, the data from these trials suggests that certain atypical antipsychotics, such as risperidone and clozapine, are effective in the short-term management of aggression in DBDs. They have no apparent effect on cognition, but are associated with significant metabolic adverse effects. The results of these trials, and of the earlier systematic reviews, are discussed in the light of global trends towards increasing off-label prescription of antipsychotic medication in children and adolescents, and of recent literature on the neuropharmacology of aggression in this patient population. The need for rational, short-term use of these drugs is highlighted, as well as the importance of post-marketing surveillance for long-term or severe adverse events.
Keywords: 
Subject: Medicine and Pharmacology  -   Psychiatry and Mental Health
Copyright: This open access article is published under a Creative Commons CC BY 4.0 license, which permit the free download, distribution, and reuse, provided that the author and preprint are cited in any reuse.
Prerpints.org logo

Preprints.org is a free preprint server supported by MDPI in Basel, Switzerland.

Subscribe

© 2024 MDPI (Basel, Switzerland) unless otherwise stated