Reviewer: Matthew J Koscica, M.D.(Northwestern University Feinberg School of Medicine)
Description: Child and adolescent psychopharmacology is a young and highly active field where change is frequent and swift, making it difficult to keep up with the relevant literature. In addition, there is an ongoing shortage of child and adolescent psychiatrists in the country, with the result that prescribing for children with certain psychiatric disorders may fall increasingly to pediatricians and other primary care clinicians who may not have extensive experience in this area. This comprehensive book, an update from the 2012 edition, addresses both these needs with a detailed review of the latest psychopharmacological literature that is accessible to all providers, regardless of their experience.
Purpose: The book collects a series of articles on a wide variety of pediatric psychiatric disorders in order to compile a meticulous, yet at once "digestible and usable" reference on pharmacology in child and adolescent psychiatry. A primary focus is on the evidence and support for the use for each medication in relevant disorders.
Audience: The audience is prescribing clinicians working in mental health, ranging from psychiatrists and advanced practice psychiatric nurses to pediatricians and family physicians.
Features: The book begins with an overview of pharmacokinetic and pharmacodynamic principles, with a particular focus on children and adolescents, rightly emphasizing that this is an area that requires careful study and specialized attention and reinforcing the fact that a simple linear interpolation based on body size could, in the context of a developing mind and a varying metabolism, yield mixed results at best, and harmful at worst. With this devotion to evidence-guided treatment principles in mind, the book then embarks on a series of chapters written by a variety of experts in the field, organized by category of disorder: major depression, psychotic disorders, autism spectrum disorder, etc., with a final chapter on eating disorders that is new to this edition. The structure of each chapter varies, but they generally begin with a short description of epidemiology and clinical features of a disorder before detailing each medication in use for the disorder. For each medication, there is heavy emphasis on the various studies and evidence for (or in some cases, against) its use, along with dosing recommendations, relevant drug monitoring, review of adverse effects, and drug monitoring guidelines. Many of the chapters compile information into helpful summary tables for comparison across medications, with some, such as the autism spectrum disorder chapter, also offering a flowchart for suggested prescribing strategies; the location of each table is noted the front matter for easy reference. Each chapter concludes with a short list of clinical pearls that note helpful principles to keep in mind when considering each disorder and an exhaustive list of references and citations, mainly to primary literature. The new chapter on eating disorders follows much the same format, albeit in an abbreviated fashion, as the evidence base for medications in child and adolescent eating disorders is significantly limited at the time of publication. The index helpfully organizes information for reference not only by disorder, but also by medication for quick and easy reference.
Assessment: Overall, the authors of this excellent book have succeeded in their mission to create a comprehensive manual of medications in use in the field of child and adolescent psychiatry. Each chapter contains an extensive amount of literature review that manifests in an organized and practical fashion, flexible enough to serve as a detailed introduction for new residents or fellows or as a reliable reference for experienced prescribers who simply require an overview of the modern primary literature. One concern is that the focus on evidence and clinical trials may limit the usefulness to nonprescribers in the field, such as social workers or educators who work with special needs who may want a briefer overview of medications. However, there is enough segmentation between study details and general characteristics that the book can still fulfill this purpose. Finally, while the chapter on eating disorders is a worthy addition, it is not clear exactly how much else has changed from the second edition. Nevertheless, as a complete yet readable collection of the modern relevant literature concerning psychopharmacology for children and adults, this book is an essential component of any prescriber's bookshelf.
