title: [Pharmacotherapy for conduct disorder in children and adolescents].
abstract: BACKGROUND
  Conduct disorder (CD) is a common disorder which is typified by a variety of behavioral problems and aggression. Treating CD is a challenge in the field of child and adolescent psychiatry. The use of drugs for this indication is broad despite the lack of systematic knowledge on this subject.
  
  
  OBJECTIVE
  This paper aims to review research data available on the efficacy of the different medication classes and agents for CD and to specify the considerations that should be taken accordingly.
  
  
  METHODS
  Trials on the pharmacotherapy of CD in children and adolescents are reviewed from the PubMed database (dated from 1980 until today).
  
  
  RESULTS
  Trials of antipsychotics, lithium, anti-epileptics, stimulants, alfa-2 agonists and beta-blockers were found. The use of typical antipsychotics is accompanied by major side-effects. Research on risperidone, the most investigated agent, shows it to be effective. Limited research with positive results is also available on quetiapine, olanzapine and aripiprazole. Trials of lithium yield contradictory results. Few trials with valproate suggest it to be effective for this indication. There is evidence showing the efficacy of stimulants but substance abuse is a potential risk in this population. The results for other agents are very few.
  
  
  CONCLUSIONS
  There are few well controlled studies of the pharmacotherapy of conduct disorder in children and adolescents. The most proven efficacy is for the atypical antipsychotics. Valproate or lithium may be possible second or third alternatives, based on some supporting evidence. When Attention-Deficit/Hyperactivity Disorder is diagnosed, stimulant use should be considered. Given the adverse effects profile of these agents on the one hand, and the developmental risks of avoiding medication on the other hand, a risk-benefit analysis should be conducted for each patient and adverse effects should be monitored carefully. More research is needed to broaden and deepen the knowledge on this subject.
authors.affiliation: Shalvata Mental Health Center, Hod Hasharon, Israel. tomerlev@clalit.org.il
authors.forename: Tomer
authors.initials: T
authors.lastname: Levy
authors.forename: Yuval
authors.initials: Y
authors.lastname: Bloch
mesh_terms: D000293:Adolescent; D000374:Aggression / Q000187:drug effects; D000925:Anticoagulants / Q000009:adverse effects; D018692:Antimanic Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000503:physiopathology; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D019955:Conduct Disorder / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D018020:Lithium Compounds / Q000627:therapeutic use; D014635:Valproic Acid / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D018692:Antimanic Agents; D014150:Antipsychotic Agents; D000697:Central Nervous System Stimulants; D018020:Lithium Compounds; D014635:Valproic Acid