Current pharmacotherapy options for conduct disorders in adolescents and children.

Sohil Khan, John Down, Nisreen Aouira, William Bor, Alison Haywood, Robyn Littlewood, Helen Heussler, Brett McDermott

Journal: Expert opinion on pharmacotherapy 2019;20(5):571-583

PMID: 30702354

Abstract

INTRODUCTION

Conduct disorder (CD) is a common mental health disorder of childhood and adolescence. CD's complexity, with its heterogenous clinical manifestations and overlapping comorbidities makes the application of evidence-based management approaches challenging. This article aims to combine a systematic review of the available literature, with a consensus opinion from both child and adolescent psychiatrists and developmental pediatricians on the clinical and pharmacological management of children and adolescents with conduct disorder (CD).

AREAS COVERED

The authors review the CD population and provide a systematic review and meta-analysis of the effectiveness and safety of pharmacotherapies using preferred reporting items for systematic review and meta-analysis (PRISMA) and strength of evidence recommendation taxonomy (SORT) guidelines. The authors then provide an expert clinical opinion for the use of different pharmacotherapies to address aggressive and disruptive behavior in children.

EXPERT OPINION

Atypical antipsychotics (e.g. risperidone) demonstrate evidence for efficacy in CD. Other pharmacotherapies (e.g. mood stabilizers, anticonvulsants, psychostimulants and selective norepinephrine reuptake inhibitors) have a low level of evidence for CD alone, however, can sometimes be effective in managing the symptoms of CD when other psychiatric disorders are also present.

Address: a School of Pharmacy and Pharmacology, Quality Use of Medicines Network, Menzies Health Institute , Griffith University , Gold Coast , Australia.; b Mater Research Institute , The University of Queensland , South Brisbane , Australia.; c Manipal College of Pharmaceutical Sciences , Manipal University , Manipal , India.; d Children's Health Queensland Hospital and Health Service , Lady Cilento Children's Hospital , South Brisbane , Australia.; e Child and Youth Mental Health Service , Children's Health Queensland Hospital and Health Service , South Brisbane , Australia.; f Centre for Children's Health Research , Children's Health Queensland Hospital and Health Services , South Brisbane , Australia.; g School of Human Movement and Nutrition Sciences , The University of Queensland , South Brisbane , Australia.; h Townsville Clinical School, College of Medicine and Dentistry , James Cook University , Townsville , Australia.

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