Ethical issues in psychopharmacology of children and adolescents.
OBJECTIVE
This summary of the literature published over recent years focuses on the ethical aspects of interventions with psychotropic medication in child and adolescent psychiatry. Ethical issues of pharmacotherapy concern aspects of research, safety, indicated use, enhancement, information and evidence-based practice.


RESULTS
The literature on pharmacological interventions suggests changes in prescribing patterns for some substance classes owing to regulatory authorities' warnings. For most of the commonly used medications in children and adolescents no sound database about efficacy and safety is available and knowledge about adverse events and long-term safety remains poor. This is due to a general lack of clinical trials in this population. Legislative efforts have tried to improve safety and labelling of medicines for children. Ethical issues of enhancement in minors have been increasingly discussed over recent years.


CONCLUSIONS
The ethical aspects of psychopharmacotherapy in minors are still rarely discussed in the literature. Practical questions of research and treatment ethics such as a need for information for children and parents are pointed out; conflicts of evocation and access to care for special populations in need are identified in a field lacking adequate ethical and clinical research.
Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Ulm, Ulm, Germany.
Michael
M
Koelch
Kathleen
K
Schnoor
Joerg M
JM
Fegert
D000293:Adolescent; D000296:Adolescent Psychiatry / Q000941:ethics*; D002648:Child; D002665:Child Psychiatry / Q000941:ethics*; D004995:Ethics, Professional; D006801:Humans; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology*; D011600:Psychopharmacology / Q000941:ethics*; D011619:Psychotropic Drugs / Q000009:adverse effects
D011619:Psychotropic Drugs