Psychopharmacologic treatment of children prenatally exposed to drugs of abuse.
OBJECTIVE
This pilot study compared the pharmacologic treatment history and clinical outcomes observed in pediatric outpatients with psychiatric disorders exposed to drugs of abuse in utero to those of an age-matched, sex-matched and psychiatric disorder-matched, non-drug-exposed group.


METHODS
In this matched cohort study, medical records of children treated at an academic, child and adolescent psychiatry outpatient clinic were reviewed. Children with caregiver-reported history of prenatal drug exposure were compared with a non-drug-exposed control group being cared for by the same providers. Patients were rated with the Clinical Global Impressions-Severity scale (CGI-S) throughout treatment. The changes in pre-treatment and post-treatment CGI-S scores and the total number of medication trials were determined between groups.


RESULTS
The drug-exposed group (n = 30) had a higher total number of lifetime medication trials compared with the non-drug-exposed group (n = 28) and were taking significantly more total medications, at their final assessment. Unlike the non-drug-exposed group, the drug-exposed group demonstrated a lack of clinical improvement.


CONCLUSIONS
These results suggest that in utero drug-exposed children may be more treatment-refractory to or experience greater side effects from the pharmacologic treatment of psychiatric disorders than controls, although we cannot determine if early environment or drugs exposure drives these findings.
Section of Child and Adolescent Psychiatry, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA.
Leslie A
LA
Hulvershorn
Kristen M
KM
Schroeder
Logan K
LK
Wink
Craig A
CA
Erickson
Christopher J
CJ
McDougle
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D010865:Pilot Projects; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011569:Psychiatric Status Rating Scales; D019966:Substance-Related Disorders / Q000150:complications*; D016896:Treatment Outcome
D013287:Illicit Drugs
children; prenatal drug exposure; psychopharmacology