The Handbook of Child and Adolescent Psychopharmacology, published in 2006, is a resource with international input, with editors from the United States and Italy and contributors from both Italy and Brazil. According to the editors, the aims of the book are two fold: 1) to provide clinicians with useful information related to the use of psychotropic medications in the treatment of children and adolescents with mental disorders and 2) to ultimately contribute to the practice of evidence-based medicine in this area.
The book is extensive in its coverage of psychopharmacology as it relates to the pediatric population. In particular, a four-page introduction provides a primer on psychopharmacology in the developmental ages, and this introduction is followed by a chapter on essential concepts for practicing evidence-based pediatric psychopharmacology. The remaining chapters focus on treatment of psychiatric disorders in children and adolescents: anxiety, major depressive, bipolar, obsessive-compulsive, Tourette syndrome, psychotic, attention deficit hyperactivity, impulsive aggression and related behaviors, eating disorders, and pervasive developmental disorders. Altogether, the book is comprised of 12 chapters.
For the most part, the handbook is organized into several well-written chapters that give a comprehensive review of the available literature on medication therapy. The 11-page index is another asset of the handbook, as many medications and assessment tools are used in multiple disorders. Reviewing pharmacology and pharmacokinetics for each medication in multiple chapters is not necessary since the index is so accessible. Finally, the international contributors promote a more extensive discussion of medication than reviews limited to agents available in the United States.
While several chapters are succinct and appropriate for a handbook, some chapters are less concise and omit charts or tables. For example, Chapter 7, “Tourette Syndrome: Treatment” has 18 authors, is 50 pages in length, and incorporates a significant amount of information outside the stated purpose of the handbook. Additional weaknesses of the book include multiple proof errors, including misspellings and misuse of words.
Although the handbook offers information on a range of disorders and their pharmacological treatments, there are still glaring omissions in the text. especially brought to the reader's attention by the text on the back cover. The back cover suggests that the handbook will provide “a thorough grounding in the neurobiology of childhood psychiatric disorders” and “an overview of the pharmacology of current psychotropic compounds” relevant to the treatment of conditions such as personality disorder, one of the conditions specifically listed on the back cover. However, there is only one page related to personality disorders, and discussion of neurobiology or treatment is lacking. While it is important to have this content in the handbook, it is misleading to assert the topic will be addressed to the extent described on the back cover. Furthermore, the phrase “thorough grounding in the neurobiology” is not an appropriate description of the content related to the pathophysiology of the disorders. The handbook also includes only superficial discussions of the mechanism(s) of medication activity; furthermore, some chapters do not underscore the relationship between the sites of drug action and the biology of the illness. Finally, there is no discussion of the neurobiology of the individual disorders beyond drug targets; a neurobiological understanding of psychiatric disorders would encompasses much more information than provided in the handbook. Such information may include brain activity, physiologic processes not currently targeted by medications, and genetics.
In conclusion, the Handbook of Child and Adolescent Psychopharmacology includes clinically useful information with respect to treating children and adolescents with psychotropic medications and highlights the need for more research to support evidence-based medication in the pediatric mental illness arena. The book, however, does not adequately address the neurobiology of the featured disorders. In addition, several chapters are lengthy and lacking a reader-friendly format. Future editions should aim to better meet stated objectives, organize chapters consistently, and incorporate more charts and tables to present data.
DISCLOSURE The reviewer declares no conflicts or financial interest in any product or service mentioned in the manuscript, including grants, equipment, medications, employment, gifts, and honoraria.