For better or worse, we are prescribing atypical antipsychotics more frequently in children. Some of this is due to new FDA indications for kids (autism, psychotic disorders, and bipolar disorder), but much of the increase is driven by off-label use (Tourette’s, ADHD, OCD, depression, conduct disorder and impulse control disorders).
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In 2011, we wrote a review of medications for PTSD in children and found, unfortunately, that data to inform true evidence-based practice was scant. There are still no psychotropic medications that have been proven effective in randomized controlled trials for children with PTSD and there are no FDA approved medications for this population.
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Learn about Trauma Systems Therapy (TST) and its use with young patients in an interview with Glenn Saxe, MD, Arnold Simon professor and chair, Department of Child and Adolescent Psychiatry, and director, the Child Study Center.
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Autism is fairly common and is extremely hard to treat. A couple of antipsychotics (Risperdal, Abilify) can help decrease the agitation common in autism, and some behavior therapies can improve the ability to interact with others. But these behavioral techniques have only been studied in the short term—which is not very helpful, because autism is a long term problem.
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Dr. Joshua Feder studied mathematics and medicine at Boston University, Psychiatry at Naval Regional Medical Center San Diego, serving the first Gulf War in child and adolescent psychiatry fellowship at Tripler Army Medical Center in Honolulu, and eventually became Chief of Child Psychiatry at the National Naval Medical Center in Bethesda, MD. Dr. Feder now practices in Solana Beach, California, and serves as Executive Medical Director at Positive Development, providing relationship-based support for families, with research at UCSD, SDSU, Fielding Graduate University, An Najah National University, Quicksilver Software, Autism Is inclusion program, and Programmatic Lead for the International Networking Group on Peace Building with Young Children, with projects in the US, Northern Ireland, and the Middle East. Dr. Feder co-authored the first American Academy of Child & Adolescent Psychiatry Practice Parameter on Autism and serves as Co-Chair of the Disaster & Trauma Committee at AACAP. Dr Feder was founding policy chair for the California Association for Infant Mental Health and advocates worldwide on access to care, climate policy, and peacebuilding. His recent books include Child Medication Fact Book for Psychiatric Practice, Second Edition (2023) and Prescribing Psychotropics (2021).
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