Abstract
A robust evidence base exists for the use of CBT to shape behavior and treat various disorders in youth. There are also strong empirical data to support the use of pharmacological agents in children and adolescents to accomplish behavioral change and for the management of various conditions, including anxiety, depression, posttraumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), bipolar disorder, psychosis, tics, insomnia, and attention-deficit/hyperactivity disorder (ADHD). Numerous studies have found the combination of CBT and medication to be most effective for treating many of these illnesses. In this chapter, we will discuss general principles and specific strategies for pharmacological intervention and focus on disorders where the combined use of medication and CBT has been well studied and is relevant to the treatment of children and adolescents coping with pediatric medical conditions.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Achenbach, T. M. (1991a). Manual for the child behavior checklist/ 4–18 and 1991 profile. Burlington, VT: University of Vermont, Department of Psychiatry.
Achenbach, T. M. (1991b). Manual for the youth self-report and 1991 profile. Burlington, VT: University of Vermont, Department of Psychiatry.
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.
Berard, R., Fong, R., Carpenter, D. J., Thomason, C., & Wilkinson, C. (2006). An international, multicenter, placebo-controlled trial of paroxetine in adolescents with major depressive disorder. Journal of Child and Adolescent Psychopharmacology, 16(1–2), 59–75.
Birmaher, B., Brent, D. A., Chiappetta, L., Bridge, J., Monga, S., & Baugher, M. (1999). Psychometric properties of the screen for child anxiety related emotional disorders (SCARED): A replication study. Journal of the American Academy of Child and Adolescent Psychiatry, 38(10), 1230–1236.
Birmaher, B., Axelson, D. A., Monk, K., Kalas, C., Clark, D. B., Ehmann, M., et al. (2003). Fluoxetine for the treatment of childhood anxiety disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 42(4), 415–423.
Bridge, J. A., Iyengar, S., Salary, C. B., Barbe, R. P., Birmaher, B., Pincus, H. A., et al. (2007). Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: A meta-analysis of randomized controlled trials. Journal of the American Medical Association, 297(15), 1683–1696.
Brooks, R. K., & Strawn, J. R. (2014). Psychological and pharmacologic treatment of youth with posttraumatic stress disorder-an evidence-based review. Child and Adolescent Psychiatric Clinics of North America, 23, 399–411.
Brosbe, M. S., Faust, J., & Gold, S. N. (2013). Complex traumatic stress in the pediatric medical setting. Journal of Trauma & Dissociation, 14, 97–112.
Brown, L. K., Kennard, B. D., Emslie, G. J., Mayes, T. L., Whiteley, L. B., Bethel, J., et al. (2016). Effective treatment of depressive disorders in medical clinics for adolescents and young adults living with HIV: A controlled trial. Journal of Acquired Immune Deficiency Syndromes, 71(1), 38–46.
Bursch, B., & Forgey, M. (2013). Psychopharmacology for medically ill adolescents. Current Psychiatry Reports, 15(10), 395.
Cipriani, A., Zhou, X., Del Giovane, C., Hetrick, S. E., Qin, B., Whittington, C., et al. (2016). Comparative efficacy and tolerability of antidepressants for major depressive disorder in children and adolescents: A network meta-analysis. Lancet, 388, 881–890.
Cohen, J. A., Mannarino, A. P., Perel, J. M., & Staron, V. (2007). A pilot randomized controlled trial of combined trauma-focused CBT and sertraline for childhood PTSD symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 46(7), 811–819.
Connor, D. F., Grasso, D. J., Slivinsky, M. D., Pearson, G. S., & Banga, A. (2013). An open-label study of guanfacine extended release for traumatic stress related symptoms in children and adolescents. Journal of Child and Adolescent Psychopharmacology, 23(4), 244–251.
Creswell, C., & Waite, P. (2016). Recent developments in the treatment of anxiety disorders in children and adolescents. Evidence-Based Mental Health, 19(3), 65–68.
Emslie, G. J., Wagner, K. D., Kutcher, S., Krulewicz, S., Fong, R., Carpenter, D. J., et al. (2006). Paroxetine treatment in children and adolescents with major depressive disorder: A randomized, multicenter, double-blind, placebo-controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 45(6), 709–719.
Emslie, G. J., Ventura, D., Korotzer, A., Tourkodimitris, S., et al. (2009). Escitalopram in the treatment of adolescent depression: A randomized placebo-controlled multisite trial. Journal of the American Academy of Child and Adolescent Psychiatry, 48(7), 721–729.
Famularo, R., Kinscherff, R., & Fenton, T. (1988). Propranolol treatment for childhood posttraumatic stress disorder, acute type. A pilot study. The American Journal of Diseases of Children, 142(11), 1244–1247.
Foa, E. B., Johnson, K. M., Feeny, N. C., & Treadwell, K. R. H. (2001). The child PTSD symptom scale: A preliminary examination of its psychometric properties. Journal of Clinical Child Psychology, 30(3), 376–384.
Gibbons, R. D., Brown, C. H., Hur, K., Marcus, S. M., Bhaumik, D. K., Erkens, J. A., et al. (2007). Early evidence on the effects of regulators’ suicidality warnings on SSRI prescriptions and suicide in children and adolescents. American Journal of Psychiatry, 164(9), 1356–1363.
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry, 23, 56–62.
Hammad, T. A., Laughren, T., & Racoosin, J. (2006). Suicidality in pediatric patients treated with antidepressant drugs. Archives of General Psychiatry, 63(3), 332–339.
Harmon, R. J., & Riggs, P. D. (1996). Clonidine for posttraumatic stress disorder in preschool children. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 1247–1249.
Horrigan, J. P., & Barnhill, L. J. (1999). Risperidone and PTSD in boys. The Journal of Neuropsychiatry and Clinical Neurosciences, 11, 126–127.
Ipser, J. C., Stein, D. J., Hawkridge, S., & Hoppe, L. (2010). Pharmacotherapy for anxiety disorders in children and adolescents (review). The Cochrane Collaboration, 6, 1–72.
Keeshin, B. R., & Strawn, J. R. (2014). Psychological and pharmacologic treatment of youth with posttraumatic stress disorder: an evidence-based review. Child and Adolescent Psychiatric Clinics of North America, 23(2), 399–411.
Keller, M. B., Ryan, N. D., Strober, M., Klein, R. G., Kutcher, S. P., Birmaher, B., et al. (2001). Efficacy of paroxetine in the treatment of adolescent major depression: A randomized, controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 40(7), 762–772.
Kolves, K., & De Leo, D. (2016). Adolescent suicide rates between 1990 and 2009: Analysis of age group 15-19 years worldwide. Journal of Adolescent Health, 58, 69–77.
Kovacs, M. (1985). The children’s depression inventory (CDI). Psychopharmacology Bulletin, 21(4), 995–998.
Locher, C., Koechlin, H., Zion, S. R., Werner, C., Pine, D. S., Kirsch, I., et al. (2017). Efficacy and safety of serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and placebo for common psychiatric disorders among children and adolescents: A systematic review and meta-analysis. JAMA Psychiatry, 74(10), 1011–1020.
Looff, D., Grimley, P., Kuller, F., Martin, A., & Shonfield, L. (1995). Carbamazepine for PTSD. Journal of the American Academy of Child and Adolescent Psychiatry, 34(6), 703–704.
March, J. S., & Vitiello, B. (2009). Clinical messages from the treatment for adolescents with depression study (TADS). American Journal of Psychiatry, 166(10), 1118–1123.
March, J. S., Parker, J. D. A., Sullivan, K., Stallings, P., & Conners, C. K. (1997). The multidimensional anxiety scale for children (MASC): Factor structure, reliability, and validity. Journal of the American Academy of Child and Adolescent Psychiatry, 36(4), 554–565.
Meighen, K. G., Hines, L. A., & Lagges, A. M. (2007). Risperidone treatment of preschool children with thermal burns and acute stress disorder. Journal of Child and Adolescent Psychopharmacology, 17(2), 223–232.
Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., et al. (2010). Lifetime prevalence of mental disorders in us adolescents: Results from the national comorbidity survey replication—Adolescent supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49, 980–989.
Nugent, N. R. (2007). The efficacy of early propranolol administration at preventing/reducing PTSD symptoms in child trauma victims: Pilot. Dissertation, Kent State University.
Park, E. M., & Rosenstein, D. L. (2015). Depression in adolescents and young adults with cancer. Dialogues in Clinical Neuroscience, 17(2), 171–180.
Perry, B. D. (1994). Neurobiological sequelae of childhood trauma: PTSD in children. In M. M. Murburg (Ed.), Catecholamine function in posttraumatic stress disorder: Emerging concepts (pp. 233–255). Washington, DC: American Psychiatric Press.
Piacentini, J., Bennett, S., Compton, S. N., Kendall, P. C., Birmaher, B., Albano, A. M., et al. (2014). 24- and 36-week outcomes for the child/adolescent anxiety multimodal study (CAMS). Journal of the American Academy of Child and Adolescent Psychiatry, 53(3), 297–310.
Robb, A. S., Cueva, J. E., Sporn, J., Yang, R., & Vanderburg, D. G. (2010). Sertraline treatment of children and adolescents with posttraumatic stress disorder: A double-blind, placebo-controlled trial. Journal of Child and Adolescent Psychopharmacology, 20(6), 463–471.
Rynn, M. A., Riddle, M. A., Yeung, P. P., & Kunz, N. R. (2007). Efficacy and safety of extended-release venlafaxine in the treatment of generalized anxiety disorder in children and adolescents: Two placebo-controlled trials. American Journal of Psychiatry, 164(2), 290–300.
Rzucidlo, S. E., & Campbell, M. (2009). Beyond the physical injuries: Child and parent coping with medical traumatic stress after pediatric trauma. Journal of Trauma Nursing, 16(3), 130–135.
Sakolsky, D., & Birmaher, B. (2012). Developmentally informed pharmacotherapy for child and adolescent depressive disorders. Psychiatric Clinics of North America, 21, 313–325.
Seedat, S., Lockhat, R., Kaminer, D., Zungu-Dirwayi, N., & Stein, D. J. (2001). An open trial of citalopram in adolescents with post-traumatic stress disorder. International Clinical Psychopharmacology, 16(1), 21–25.
Seedat, S., Stein, D. J., Ziervogel, C., Middleton, T., Kaminer, D., Emsley, R. A., et al. (2002). Comparison of response to a selective serotonin reuptake inhibitor in children, adolescents, and adults with posttraumatic stress disorder. Journal of Child and Adolescent Psychopharmacology, 12(1), 37–46.
Shatkin, J. P. (2015). Child & adolescent mental health-a practical, all-in-one guide (2nd ed.). New York: W.W. Norton.
Stathis, S., Martin, G., & McKenna, J. G. (2005). A preliminary case series on the use of quetiapine for posttraumatic stress disorder in juveniles within a youth detention center. Journal of Clinical Psychopharmacology, 25(6), 539–544.
Steinberg, A. M., Brymer, M., Decker, K., & Pynoos, R. S. (2004). The University of California at Los Angeles post-traumatic stress disorder reaction index. Current Psychiatry Reports, 6, 96–100.
Steiner, H., Saxena, K. S., Carrion, V., Khanzode, L. A., Silverman, M., & Chang, K. (2007). Divalproex sodium for the treatment of PTSD and conduct disordered youth: A pilot randomized controlled clinical trial. Child Psychiatry and Human Development, 38(3), 183–193.
Strawn, J. R., Prakash, A., Zhang, Q., Pangallo, B. A., Stroud, C. E., Cai, N., et al. (2015a). A randomized, placebo-controlled study of duloxetine for the treatment of children and adolescents with generalized anxiety disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 54(4), 283–293.
Strawn, J. R., Welge, J. A., Wehry, A. M., Keeshin, B. R., & Rynn, M. A. (2015b). Efficacy and tolerability of antidepressants in pediatric anxiety disorders: A systematic review and meta-analysis. Depression and Anxiety, 32(3), 149–157.
Strawn, J. R., Mills, J. A., Sauley, B. A., & Welge, J. A. (2018). The impact of antidepressant dose and class on treatment response in pediatric anxiety disorders: A meta-analysis. Journal of the American Academy of Child and Adolescent Psychiatry, 57(4), 235–244.
The Research Unit on Pediatric Psychopharmacology Anxiety Study Group. (2001). Fluvoxamine for the treatment of anxiety disorders in children and adolescents. New England Journal of Medicine, 344(17), 1279–1285.
Uthman, O. A., & Abdulmalik, J. (2010). Comparative efficacy and acceptability of pharmacotherapeutic agents for anxiety disorders in children and adolescents: A mixed treatment comparison meta-analysis. Current Medical Research and Opinion, 26(1), 53–59.
Varigonda, A. L., Jakubovski, E., Taylor, M. J., Freemantle, N., Coughlin, C., & Bloch, M. H. (2015). Systematic review and meta-analysis: Early treatment responses of selective serotonin reuptake inhibitors in pediatric major depressive disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 54(7), 557–564.
von Knorring, A. L., Olsson, G. I., Thomsen, P. H., Lemming, O. M., & Hulten, A. (2006). A randomized, double-blind, placebo-controlled study of citalopram in adolescents with major depressive disorder. Journal of Clinical Psychopharmacology, 26(3), 311–315.
Wagner, K. D., Ambrosini, P., Rynn, M., Wohlberg, C., Yang, R., Greenbaum, M. S., et al. (2003). Efficacy of sertraline in the treatment of children and adolescents with major depressive disorder: Two randomized controlled trials. Journal of the American Medical Association, 290(8), 1033–1041.
Wagner, K. D., Robb, A. S., Findling, R. L., Jin, J., Gutierrez, M. M., & Heydorn, W. E. (2004). A randomized, placebo-controlled trial of citalopram for the treatment of major depression in children and adolescents. American Journal of Psychiatry, 161(6), 1079–1083.
Wagner, K. D., Jonas, J., Findling, R. L., Ventura, D., & Saikali, K. (2006). A double-blind, randomized, placebo-controlled trial of escitalopram in the treatment of pediatric depression. Journal of the American Academy of Child and Adolescent Psychiatry, 45(3), 280–288.
Walkup, J. T., Albano, A. M., Piacentini, J., Birmaher, B., Compton, S. N., Sherrill, J. T., et al. (2008). Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. New England Journal of Medicine, 359(26), 2753–2766.
Xu, Y., Bai, S. J., Lan, X. H., Qin, B., Huang, T., & Xie, P. (2016). Randomized controlled trials of serotonin-norepinephrine reuptake inhibitor in treating major depressive disorder in children and adolescents: A meta-analysis of efficacy and acceptability. Brazilian Journal of Medical and Biological Research, 49(6), 1–8.
Zohar, J., Juven-Wetzler, A., Sonnino, R., Cwikel-Hamzany, S., Balaban, E., & Cohen, H. (2011). New insights into secondary prevention in post-traumatic stress disorder. Dialogues in Clinical Neuroscience, 13(3), 301–309.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Jummani, R.R., Shatkin, J.P. (2019). Pharmacological Interventions. In: Friedberg, R.D., Paternostro, J.K. (eds) Handbook of Cognitive Behavioral Therapy for Pediatric Medical Conditions. Autism and Child Psychopathology Series. Springer, Cham. https://doi.org/10.1007/978-3-030-21683-2_11
Download citation
DOI: https://doi.org/10.1007/978-3-030-21683-2_11
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-21682-5
Online ISBN: 978-3-030-21683-2
eBook Packages: Behavioral Science and PsychologyBehavioral Science and Psychology (R0)