Pharmacotherapy of Aggression in a 9-Year-Old With ADHD

 This is a case vignette created to exemplify a complex clinical problem and does not refer to any specific patient.This column aims to discuss practical approaches to everyday issues in pediatric pharmacotherapy. The cases and discussions specifically target aspects of clinical care related to psychopharmacology for which we do not have adequate applicable controlled trials. Given the need to address symptoms in youths with complex, severe, and comorbid disorders, recommendations are likely to be “off label” from the perspective of the U.S. Food and Drug Administration. We fully appreciate that for virtually all disorders, medication is only one aspect of comprehensive care. This column focuses primarily on psychopharmacologic management. Although it is important that clinicians address psychosocial issues in the evaluation and treatment of their patients, such discussion is beyond the specific scope of this feature. These are not meant to be practice guidelines, but rather examples of thought processes that may go into pharmacotherapy decision making.Disclosure: Dr. Findling receives or has received research support from, acted as a consultant to, or served on a speakers' bureau of Abbott, AstraZeneca, Bristol-Myers Squibb, Celltech-Medeva, Forest, GlaxoSmithKline, Johnson & Johnson, Lilly, New River, Novartis, Otsuka, Pfizer, Shire, Sanofi-Aventis, Solvay, and Wyeth. Dr. Malone has received investigator-initiated funding from Eli Lilly, Pfizer, and Bristol-Myers Squibb and served as a consultant to Eli Lilly. Dr. Prince is a member of the speakers' bureaus of McNeil and Janssen; has received honoraria from Shire, Novartis, and Cephalon; and has been a consultant to Shire, Novartis, Cephalon, and McNeil. Dr. Kratochvil has received grant support from, is a consultant to, and/or member of the speakers' bureaus of Eli Lilly, GlaxoSmithKline, Forest, Shire, Cephalon, Novartis, McNeil, Organon, AstraZeneca, and Pfizer. Dr. Newcorn receives research support from McNeil Pediatrics and Eli Lilly and is a consultant to, advisor to, or speaker for McNeil Pediatrics, Shire, Novartis, Eli Lilly, Cephalon, Cortex, and Pfizer. Dr. Waheed has no financial relationships to disclose.

PII: S0890-8567(09)61725-1

doi:10.1097/chi.0b013e3180335b4a

© 2007 The American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.