Child and Adolescent Psychopharmacology

Development is probably best viewed as continuous across the life span, with changes in internal and external environments constantly affecting each other to produce modifications in mood, thought, and behavior. Because these modifications are most pronounced in childhood and adolescence, a developmental approach is a necessity in all fields of medicine dealing with this age group. Rather than focus exclusively on biologic, psychological, or social development, this article discusses pediatric psychopharmacology within the general framework of the biopsychosocial model. 27 This article focuses on various issues as they are relevant to this discussion, reviewing some key differences between children, adolescents, and adults as they affect the practice of pediatric psychopharmacology. The article begins with an overview of developmental variations in pharmacokinetics and pharmacodynamics. Afterward, a comment is made on the developmental state of the field of pediatric psychopharmacology. The article then discusses issues related to decision making before beginning treatment with medication, including diagnosis, impairment, and consent. Subsequently, specific disorders, such as attention-deficit hyperactivity disorder (ADHD), mood disorders, and obsessive-compulsive disorder (OCD), are briefly discussed, with focus on issues relevant to a developmental approach to pediatric psychopharmacology.