|| Use of Neuroleptics in Children
|| Mary Ann Richardson and Gary Haugland
|| American Psychiatric Press, Inc ©1996
American Psychiatric Press, Inc.
1400 K Street NW
Washington, D.C. 20005
For professionals who deal with children who may be showing various
levels of disturbance, at least a rudimentary knowledge of drugs often
prescribed for children can be very useful. This 215-page book for
clinicians, intended to be a summary of research on using tranquilizing
drugs with children, can be useful to many others as well. It is
essentially a brief introduction to the basis upon which drugs may be
prescribed, how they must be controlled and monitored, and what cautions
need to be expressed.
An observation repeated throughout the book is that psychosis and
schizophrenia are quite rare among children. There is not a great deal
of need for the use of these powerful tranquilizing agents. While there
may be benefits from these powerful medications for some limited
problematic behaviors, i.e. Tourette's Syndrome, the side effects need
to be considered whenever they are prescribed. The book reports on two
basic side effects which may be associated with the drugs. They are the
neurological deficits which may occur in either Parkinsonian symptoms or
Tardive Diskenesia and the cognitive impairment which may also result
from using the drugs. A third side effect has been noted with children
treated with neuroleptics for Tourette's Syndrome. This is the
development of noncompliant, oppositional, and aggressive behaviors that
may warrant a diagnosis of personality disorder. The side effects occur
with sufficient frequency that the main message of the book is that
selection of medication, dosages, frequency, and duration of treatment
must be monitored very carefully and thoroughly. Many of the research
studies reported are of rather poor quality involving uncontrolled and
small samples and relatively limited measurement of either base rates or
post treatment effects. A welcome suggestion, which may also generalize
to other issues involving children, is the endorsement of videotaping
children's behavior in order to have some base rate information about
their level of functioning and actual problems.
Nonmedically trained professionals who deal with children will
benefit from this book.
Reviewed by Ralph Underwager, Institute for Psychological Therapies, Northfield, Minnesota 55057.