Atypical antipsychotics in the treatment of pathological aggression in children and adolescents: literature review and clinical recommendations.
OBJECTIVE
To review the literature about the use of atypical antipsychotics in the treatment of pathological aggression in children and adolescents.


METHODS
The databases MEDLINE, SciELO, and LILACS were searched for publications in Portuguese or English from 1992 to August 2011 using the following keywords: mental disease, child, adolescent, treatment, atypical antipsychotic, aggressive behavior, aggression, and violent behavior.


RESULTS
Sixty-seven studies of good methodological quality and clinical interest and relevance were identified. Studies including children and adolescents were relatively limited, because few atypical antipsychotics have been approved by the Food and Drug Administration (FDA). All the medications included in this review (risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole and clozapine) have some effectiveness in treating aggression in children and adolescents, and choices should be based on clinical indications and side effects.


CONCLUSIONS
There are few studies about the effectiveness and safety of atypical antipsychotics for the pediatric population, and further randomized controlled studies with larger groups of patients and more diagnostic categories, such as severe conduct disorder and oppositional defiant disorder, should be conducted to confirm the results reported up to date and to evaluate the impact of long-term use.
School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil.
Eduardo Henrique
EH
Teixeira
Child and Adolescent Psychiatry Outpatient Unit, Hospital de Clínicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
Antonio
A
Jacintho
Child and Adolescent Psychiatry Outpatient Unit, HC, Unicamp, Campinas, SP, Brazil.
Heloisa Valler
HV
Celeri
Department of Medical Psychology and Psychiatry, School of Medical Sciences, UNICAMP, Campinas, SP, Brazil.
Paulo
P
Dalgalarrondo