Most psychotropic prescribing for children falls to non-specialists—a child psychiatrist shares hard-won pearls on dosing, consent, and family dynamics.

The placebo effect is real, measurable, and often stronger in children than adults, yet it’s routinely underused. This update explains the neurobiology behind placebo response, how "placebo by proxy" shapes outcomes through caregiver expectations, and how to use open-label placebo approaches ethically and effectively in everyday clinical practice.

Irritability in pediatric ADHD often persists despite stimulant treatment, yet targeted options are limited. Could an NMDA antagonist already sitting on pharmacy shelves offer a safer adjunct? A small pilot trial reports a striking early signal.

Newer antipsychotics promise novel mechanisms and fewer metabolic headaches, but the pediatric data have not caught up with the enthusiasm. This update cuts through the excitement around lumateperone, xanomeline-trospium, and TAAR1 agonists, and offers a practical framework for deciding when, if ever, to venture beyond the tried-and-true SGAs.

SSRIs are among the most prescribed medications in adolescents, but are we paying close enough attention to what they may be doing to pubertal growth? A prospective cohort study found dose-related reductions in height velocity, with changes in growth hormone signaling suggesting a possible biologic mechanism.