Drug treatment of conduct disorder in young people.
Although conduct disorder (CD) is the most common psychiatric disorder in youth from the community and encompasses one third to one half of all referrals to child and adolescent clinics, there is no licensed drug, to date, for treatment of CD, neither in Europe nor in the US. The aims of this paper are to review research data available on the use of medication for CD in young people and to identify future directions for research. We review 17 controlled studies and six open trials. Investigated compounds mainly belong to three classes of psychotropic drugs: mood stabilizers, neuroleptics and stimulants (six, five and six controlled studies, respectively). Lithium is the most documented treatment (3/4 positive studies). Conventional neuroleptics have been most commonly prescribed (3/3 positive studies), atypical neuroleptics appear promising (2/2 positive studies). Methylphenidate improves some CD symptoms, even in the absence of ADHD (6/6 positive studies). Sparse research has been conducted on response to antidepressants. The evidence for an effective role of pharmacotherapy in CD is still limited. Treatment should be multimodal and individualized to each patient's specific condition.
Service de Psychiatrie de l'Enfant et de l'Adolescent, Pavillon Clerambault, Groupe-Hospitalier Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75651 Paris Cedex 13, France.
Priscille
P
Gérardin
David
D
Cohen
Philippe
P
Mazet
Martine F
MF
Flament
D000293:Adolescent; D000316:Adrenergic alpha-Agonists / Q000494:pharmacology / Q000627:therapeutic use; D000927:Anticonvulsants / Q000494:pharmacology / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000494:pharmacology / Q000627:therapeutic use; D002220:Carbamazepine / Q000494:pharmacology / Q000627:therapeutic use; D000697:Central Nervous System Stimulants / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D002653:Child Behavior Disorders / Q000188:drug therapy*; D002675:Child, Preschool; D003000:Clonidine / Q000494:pharmacology / Q000627:therapeutic use; D019955:Conduct Disorder / Q000188:drug therapy*; D006801:Humans; D008094:Lithium / Q000494:pharmacology / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D014635:Valproic Acid / Q000494:pharmacology / Q000627:therapeutic use
D000316:Adrenergic alpha-Agonists; D000927:Anticonvulsants; D014150:Antipsychotic Agents; D000697:Central Nervous System Stimulants; D002220:Carbamazepine; D014635:Valproic Acid; D008094:Lithium; D003000:Clonidine