title: Pharmacotherapy of conduct disorder: Challenges, options and future directions.
abstract: There is a critical need for evaluation of the pharmacotherapies used in conduct disorder (CD), due to the high incidence of off-label prescribing. The aim of this review was to identify concerns associated with the safety, efficacy and impact on quality of life (QOL) that pharmacotherapy has in children and adolescents with CD. A systematic review was undertaken using pre-defined search criteria and four databases, including reference searches. We assessed these studies using the Strength of Recommendation Taxonomy, Grading of Recommendations Assessment, Development and Evaluation, and Review Manager Risk of Bias (RevMan®) tools. There were 12 randomised controlled trials that met our inclusion criteria.
  
  
  
  antipsychotics, atomoxetine, lithium, clonidine, divalproex sodium and psychostimulants. The antipsychotics demonstrated efficacy, but were associated with adverse effects. Other agents demonstrated mixed responses, highlighting the lack of clinical significance and increased incidence of adverse effects. The management of related adverse effects was addressed to assist with clinical gaps. Overall, there is limited evidence regarding the role of pharmacotherapy in CD. More research is needed that takes into account the heterogeneity of CD and analysis of pharmacotherapy in pure CD.
authors.affiliation: School of Pharmacy, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Hambly
authors.affiliation: School of Pharmacy, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia Mater Research Institute - The University of Queensland, Brisbane, QLD, Australia Manipal College of Pharmaceutical Sciences, Manipal University, Manipal, India s.khan@griffith.edu.au.
authors.forename: Sohil
authors.initials: S
authors.lastname: Khan
authors.affiliation: Townsville Clinical School, College of Medicine and Dentistry, James Cook University, Queensland, QLD, Australia.
authors.forename: Brett
authors.initials: B
authors.lastname: McDermott
authors.affiliation: Mater Research Institute - The University of Queensland, Brisbane, QLD, Australia Child and Youth Mental Health Service, Centre for Children's Health Research, Queensland Health, Brisbane, QLD, Australia.
authors.forename: William
authors.initials: W
authors.lastname: Bor
authors.affiliation: School of Pharmacy, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia Mater Research Institute - The University of Queensland, Brisbane, QLD, Australia.
authors.forename: Alison
authors.initials: A
authors.lastname: Haywood
mesh_terms: D000818:Animals; D014150:Antipsychotic Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D000697:Central Nervous System Stimulants / Q000494:pharmacology / Q000627:therapeutic use; D019955:Conduct Disorder / Q000188:drug therapy*; D006801:Humans; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic
chemical_list: D014150:Antipsychotic Agents; D000697:Central Nervous System Stimulants
keywords: Adverse effects; children; conduct disorder; drugs; efficacy; pharmacotherapy; quality of life; review; safety; young patients; youth