Psychofarmaca bij kinderen: Eén aanpak, naast andere

ADHD, anxiety disorders, obsessive compulsive disorder and autism are among the frequently diagnosed disorders in child psychiatry. The recognition that neurobiological factors contribute to the development of these disorders has resulted in an increased use of drugs to relieve the symptoms. Psychopharmacological treatment supports the effects of other treatments such as psychotherapy. The present article summarises the most common psychiatric disorders in childhood as well as the effects and side effects of psychoactive drugs in children. The effectiveness of methylphenidate on symptoms of ADHD has been demonstrated in a number of placebo-controlled randomised studies. In about 30% of children the drug is ineffective or induces side effects. Comparative studies have shown antidpressants to be similarly or less effective than the stimulants. The use of antidepressants in childhood depression is not supported by placebo-controlled, randomized studies in children. The effects are only demonstrated in open label studies. The effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in anxiety disorders have been shown in a number of placebo-controlled randomised studies. In a limited number of placebo-controlled studies haloperidol has been shown to improve symptoms of autism in only part of treated children.