Treatment of Adolescents with

The main aim of this chapter is to review the current pharmacological treatments for children and adolescents with MDD. Although psychotherapy interventions, including cognitive behavior therapy (CBT) and interpersonal psychotherapy (IPT) have also been found efficacious for the acute treatment of adolescents with MDD (e.g., Brent et ah, 1997 Mufson et ah, 1999), they will not be reviewed here. 

Kutcher, S. and Mackensie, S. (1988). Successful clonazepam treatment of adolescents with panic disorder. / Clin Psychopharmacol 18 299-301. 

Wheatley M, Plant J, Reader H, Brown G, Cahill C. Clozapine treatment of adolescents with posttraumatic stress disorder and psychotic symptoms. J Chn Psychopharmacol 2004 24 167-73. 

Results have been reported from the Treatment of Adolescents with Depression Study (TADS) 6 ], in which 439 adolescents were randomly allocated to 12 weeks of fluoxetine, cognitive behavioral therapy, the combination of these, or clinical... 

Findling RL, Robb A, Nyilas M, Forbes RA, Jin N, Ivanova S, Marcus R, McQuade RD, Iwamoto T, Carson WH. A multiple-center, randomized, doubleblind, placebo-controlled study of oral aripiprazole for treatment of adolescents with schizophrenia. Am J Psychiatry 2008 165(11) 1432-41. 

Dittmann RW, Meyer E, Freisleder FJ, Remschmidt H, Mehler-Wex C, Junghanss J, Hagenah U, Schulte-Markwort M, Poustka F, Schmidt MH, Schulz E, Mastele A, Wehmeier PM. Effectiveness and tolerability of olanzapine in the treatment of adolescents with schizophrenia and related psychotic disorders results from a large, prospective, open-label study. J Child Adolesc Psychopharmacol 2008 18(1) 54-69. 

Klein, R.G., Koplewicz, H.S., and Kanner, A. (1992) Imipramine treatment of children with separation anxiety disorder. J Am Acad Child Adolesc Psychiatry 31 21—28. 

In summary, there is evidence that Hypericum is effective in the treatment of adults with depression of mild to moderate severity. It appears also that patients tolerate St. John s wort well. Nevertheless, there are no reports involving children and adolescents. Until such data become available it cannot be concluded whether St. John s wort is effective in this age group. 

Riddle, M.A., Hardin, M.T., Cho, S.C., Woolston, J.T., and Leck-man, J.F. (1988) Desipramine treatment of boys with attention-deficit hyperactivity disorder and tics preliminary clinical experience. J Am Acad Child Adolesc Psychiatry 27 811-814. 

Schachar, R., Tannock, R., Cunninggham, C., and Corkum, P. (1997) Behavioral, situational, and temporal effects of treatment of ADHD with methylphenidate. J Am Acad Child Adolesc Psychiatry 36 754-763. 

Spencer, X, Biederman, J., Kerman, K., Steingard, R., and Wilens, X (1993a) Desipramine in the treatment of children with tic disorder or Xourette s syndrome and attention deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 32 354-360. 

West, S.A., Keck P.E., Jr., and McElroy, S.L. (1995) Oral loading doses in the valproate treatment of adolecents with mixed bipolar disorder. / Child Adolesc Psychopharmacol 5 225-231. 

Apter, A., Ratzoni, G., King, R., Weizman, A., lancu, I., Binder, M., and Riddle, M. (1994) Fluvoxamine open-label treatment of adolescent inpatients with obsessive-compulsive disorder or depression. J Am Acad Child Adolesc Psychiatry 33 342-348. 

Simeon, J. and Thatte, S. (1990) Treatment of adolescent obsessive-compulsive disorder with clomipramine-fluoxetine combination. Psychopharmacol Bull 26 285—290. 

King, R.A., Leonard, H., and March, J. (1998) Practice parameters on the assessment and treatment of children with obsessive compulsive disorder. / Am Acad Child Adolesc Psychiatry 37(Suppl) 27S-45S. 

Parraga, H.C., Parraga, M.L, Woodward, R.L., and Penning, P.A. (2001) Quetiapine treatment of children with Tourette s syndrome report of two cases. / Child Adolesc Psychopharmacol 11 187-191. 

Abczynska, M., Kazmirek, Z., Syguda, J., and Terminska, K. (1995) Own experience (1989-1994) in the treatment of adolescent schizophrenic paranoid syndromes with Leponex produced by Sandoz Company. Vsychiatr Pol 29 79-85. 

B. G., Snape, M., Shernoff, E.W, Williamson, K., and Cook, E.H. (2001) Double-blind, placebo-controlled study of amantadine hydrochloride in the treatment of children with autistic disorder. / Am Acad Child Adolesc Psychiatry 40 658-665. 

Another major safety concern in the treatment of youth with SUD is abuse of prescribed medications. Particular controversy has arisen around the use of stimulant medication in youth with SUD and ADHD. In one controlled study of adults, the use of methyl-phenidate (Ritalin) did not increase cocaine use or craving for cocaine (Grabowski et ah, 1997), suggesting that the abuse potential of stimulants may be overestimated. Riggs et al. (1996) did not report any difficulties with abuse when administering pemoline (Cylert) to a group of adolescents with SUD and ADHD. While Riggs and associates have observed that... 

Dummit, E.S., Klein, R.G., Tancer, N.K., Asche, B., and Martin, J. (1996) Fluoxetine treatment of children with selective mutism an open trial. / Am Acad Child Adolesc Psychiatry 35 615-621. 

We recently surveyed pharmaceutical companies producing antidepressant medication or central nervous system (CNS) stimulants for the European market. Approval for use of such drugs in children and adolescents is limited worldwide. Sertraline, clomipramine, and flu-voxamine have been approved for use in children (for some drugs down to the age of 6 years) for OCD in some European countries (the most wide spread approval being for sertraline in Austria, France, Hungary, Italy, Latvia, Norway, Portugal, Romania, Slovenia, Spain, Sweden, Switzerland, Turkey, United Kingdom, and Denmark) and countries outside Europe. Methyl-phenidate has been approved for the treatment of children with ADHD in a number of European and non-European countries (Novartis Health care A/S, personal communication). 

Research into the treatment of adolescent anxiety disorders is still in the early stages. Few studies have been conducted (compared with those regarding adults) on the effectiveness of anti-anxiety drugs in adolescents. However, as the use of these drugs continues to rise, the growing interest will continue to encourage further research into this area. 

Leonard HL, Swedo SE, Koby E, et al Treatment of OCD with CMl and desmethylimipramine in children and adolescents. Arch Gen Psychiatry 46 1088-1092, 1989... 

Spencer T, Biederman J, Wilens T, et al. Nortriptyline treatment of children with attention deficit hyperactivity disorder and tic disorder or Tourette s syndrome. J Am Acad Child Adolesc Psychiatry 1993 32 205-210. 

Creatsas G, Koliopoulos C, Mastorakos G. Combined oral contraceptive treatment of adolescent girls with polycystic ovary syndrome. Lipid profile. Ann NY Acad Sci 2000 900 245-52. 

They have been used prophylactically and therapeutically in the treatment of topical infections due to Staphylococcus aureus and other bacteria and fungi. In clinical trials, the nickel chelate of 3,4,7,8-tetramethyl-l,10-phenanthroline was effective against staphylococcal infection in the newborn, in patients undergoing obstetric surgery and in the treatment of adolescents infected with acne vulgaris139). 

March, J., Silva, S., Petrycki, S., Curry, J., Wells, K., Fairbank, J., et al. (2004). Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression Treatment for Adolescents with Depression Study (TADS) team. Journal of the American Medical Association, 292, 807-820. 

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