Skip to main content

Psychopharmakologie in der Kinder- und Jugendpsychiatrie

  • Living reference work entry
  • First Online:
Psychiatrie und Psychotherapie des Kindes- und Jugendalters

Part of the book series: Springer Reference Medizin ((SRM))

Zusammenfassung

Die Psychopharmakotherapie nimmt einen wichtigen Stellenwert in der Behandlung von psychischen Störungen bei Kindern und Jugendlichen ein. Die Effektivität verschiedener Substanzen bei Minderjährigen ist bekannt. Die Zulassungssituation bezüglich Psychopharmaka und die Studienlage insgesamt, gerade auch zu neueren Substanzen, bleibt bei Kindern und Jugendlichen aber weiterhin unbefriedigend. Ein wichtiges Thema gerade bei Minderjährigen ist die Pharmakosicherheit. Hierzu gibt es neuere Ansätze und Erkenntnisse zu vielen in der Kinder- und Jugendpsychiatrie eingesetzten Substanzen. Wirkliche Innovationen konnten in den letzten Jahren bezüglich neuer Substanzen für Kinder und Jugendliche mit psychischen Störungen nicht wirklich verzeichnet werden, auch innovative Studiendesigns, die z. B. Psychopharmakotherapie mit Psychotherapie untersuchen sind rar. Insgesamt ist die Verordnungsrate in Deutschland im internationalen Vergleich eher als moderat einzuschätzen. Schwerstkranke Patienten, wie z. B. stationär Behandelte, erhalten erwartungsgemäß am ehesten Polypharmazie.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

Literatur

  • Adegbite-Adeniyi C, Gron B, Rowles BM, Demeter CA, Findling RL (2012) An update on antidepressant use and suicidality in pediatric depression. Expert Opin Pharmacother 13(15):2119–2130. https://doi.org/10.1517/14656566.2012.726613

    Article  CAS  PubMed  Google Scholar 

  • Amerio A, Ossola P, Scagnelli F, Odone A, Allinovi M, Cavalli A, Iacopelli J, Tonna M, Marchesi C, Ghaemi SN (2018) Safety and efficacy of lithium in children and adolescents: a systematic review in bipolar illness. Eur Psychiatry 54:85–97. https://doi.org/10.1016/j.eurpsy.2018.07.012. Epub 2018 Aug 18

    Article  CAS  PubMed  Google Scholar 

  • Bachmann CJ, Wijlaars LP, Kalverdijk LJ, Burcu M, Glaeske G, Schuiling-Veninga CCM, Hoffmann F, Aagaard L, Zito JM (2017) Trends in ADHD medication use in children and adolescents in five western countries, 2005–2012. Eur Neuropsychopharmacol 27(5):484–493

    Article  CAS  Google Scholar 

  • Bielefeldt AØ, Danborg PB, Gøtzsche PC (2016) Precursors to suicidality and violence on antidepressants: systematic review of trials in adult healthy volunteers. J R Soc Med 109(10):381–392. Review

    Article  Google Scholar 

  • Bridge JA, Iyengar S, Salary CB, Barbe RP, Birmaher B, Pincus HA, Ren L, Brent DA (2007) Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis of randomized controlled trials. JAMA 297(15):1683–1696

    Article  CAS  Google Scholar 

  • Caraci F, Calabrese F, Molteni R, Bartova L, Dold M, Leggio GM, Fabbri C, Mendlewicz J, Racagni G, Kasper S, Riva MA, Drago F (2018) International union of basic and clinical pharmacology CIV: the neurobiology of treatment-resistant depression: from antidepressant classifications to novel pharmacological targets. Pharmacol Rev 70(3):475–504. https://doi.org/10.1124/pr.117.014977

    Article  CAS  PubMed  Google Scholar 

  • Cipriani A, Zhou X, Del Giovane C, Hetrick SE, Qin B, Whittington C, Coghill D, Zhang Y, Hazell P, Leucht S, Cuijpers P, Pu J, Cohen D, Ravindran AV, Liu Y, Michael KD, Yang L, Liu L, Xie P (2016) Comparative efficacy and tolerability of antidepressants for major depressive disorder in children and adolescents: a network meta-analysis. Lancet 388(10047):881–890. https://doi.org/10.1016/S0140-6736(16)30385-3

    Article  CAS  PubMed  Google Scholar 

  • Correll CU, Sheridan EM, DelBello MP (2010) Antipsychotic and mood stabilizer efficacy and tolerability in pediatric and adult patients with bipolar I mania: a comparative analysis of acute, randomized, placebo-controlled trials. Bipolar Disord 12(2):116–141. https://doi.org/10.1111/j.1399-5618.2010.00798.x

    Article  CAS  PubMed  Google Scholar 

  • Cortese S, Adamo N, Del Giovane C, Mohr-Jensen C, Hayes AJ, Carucci S, Atkinson LZ, Tessari L, Banaschewski T, Coghill D, Hollis C, Simonoff E, Zuddas A, Barbui C, Purgato M, Steinhausen HC, Shokraneh F, Xia J, Cipriani A (2018) Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. Lancet Psychiatry 5(9):727–738. https://doi.org/10.1016/S2215-0366(18)30269-4

    Article  PubMed  PubMed Central  Google Scholar 

  • Cullen KR, Amatya P, Roback MG, Albott CS, Westlund Schreiner M, Ren Y, Eberly LE, Carstedt P, Samikoglu A, Gunlicks-Stoessel M, Reigstad K, Horek N, Tye S, Lim KO, Klimes-Dougan B (2018) Intravenous ketamine for adolescents with treatment-resistant depression: an open-label study. J Child Adolesc Psychopharmacol. https://doi.org/10.1089/cap.2018.0030. [Epub ahead of print]

  • Duffy A, Heffer N, Goodday SM, Weir A, Patten S, Malhi GS, Cipriani A (2018) Efficacy and tolerability of lithium for the treatment of acute mania in children with bipolar disorder: a systematic review: a report from the ISBD-IGSLi joint task force on lithium treatment. Bipolar Disord 20(7):583–593. https://doi.org/10.1111/bdi.12690. Epub 2018 Sep 16

    Article  CAS  PubMed  Google Scholar 

  • Esposito S, Laino D, D’Alonzo R, Mencarelli A, Di Genova L, Fattorusso A, Argentiero A, Mencaroni E (2019) Pediatric sleep disturbances and treatment with melatonin. J Transl Med 17(1):77. https://doi.org/10.1186/s12967-019-1835-1

    Article  PubMed  PubMed Central  Google Scholar 

  • Findling RL, Nyilas M, Forbes RA, McQuade RD, Jin N, Iwamoto T, Ivanova S, Carson WH, Chang K (2009) Acute treatment of pediatric bipolar I disorder, manic or mixed episode, with aripiprazole: a randomized, double-blind, placebo-controlled study. J Clin Psychiatry 70(10):1441–1451. https://doi.org/10.4088/JCP.09m05164yel

    Article  CAS  PubMed  Google Scholar 

  • Franke C, Fegert JM, Krüger U, Kölch M (2016) Verordnungshäufigkeiten von Psychopharmaka bei Kindern und Jugendlichen mit psychischen Erkrankungen in Deutschland. Z Kinder Jugendpsychiatr 44(4):259–274

    Article  Google Scholar 

  • Gerlach MW, Walitza, Warnke W (Hrsg) (2016) Neuropsychopharmaka im Kindes- und Jugendalter, 3. akt. Aufl. Springer, Berlin/Heidelberg

    Google Scholar 

  • Gibbons RD, Brown CH, Hur K, Davis J, Mann JJ (2012) Suicidal thoughts and behavior with antidepressant treatment: reanalysis of the randomized placebo-controlled studies of fluoxetine and venlafaxine. Arch Gen Psychiatry 69(6):580–587. https://doi.org/10.1001/archgenpsychiatry.2011.2048

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Glaeske G, Schicktanz C (2013) BARMER GEK Arzneimittelreport 2013, Schriftenreihe zur Gesundheitsanalyse, Bd 20. Asgard Verlagsservice, Siegburg

    Google Scholar 

  • Glennon J, Purper-Ouakil D, Bakker M, Zuddas A, Hoekstra P, Schulze U, Castro-Fornieles J, Santosh PJ, Arango C, Kölch M, Coghill D, Flamarique I, Penzol MJ, Wan M, Murray M, Wong IC, Danckaerts M, Bonnot O, Falissard B, Masi G, Fegert JM, Vicari S, Carucci S, Dittmann RW, Buitelaar JK (2014) PERS Consortium Paediatric European Risperidon Studies (PERS): context, rationale, objectives, strategy and challenges. Eur Child Adolesc Psychiatry 23(12):1149–1160

    Article  Google Scholar 

  • Grant B, Salpekar JA (2018) Using lithium in children and adolescents with bipolar disorder: efficacy, tolerability, and practical considerations. Paediatr Drugs 20(4):303–314. https://doi.org/10.1007/s40272-018-0289-x

    Article  CAS  PubMed  Google Scholar 

  • Gründer G, Benkert O (Hrsg) (2012) Handbuch der psychiatrischen Pharmakotherapie, 2. Aufl. Berlin\Heidelberg:Springer

    Google Scholar 

  • Haas M, Delbello MP, Pandina G, Kushner S, Van Hove I, Augustyns I, Quiroz J, Kusumakar V (2009) Risperidone for the treatment of acute mania in children and adolescents with bipolar disorder: a randomized, double-blind, placebo-controlled study. Bipolar Disord 11(7):687–700. https://doi.org/10.1111/j.1399-5618.2009.00750.x

    Article  CAS  PubMed  Google Scholar 

  • Harmer CJ, Duman RS, Cowen PJ (2017) How do antidepressants work? New perspectives for refining future treatment approaches. Lancet Psychiatry 4(5):409–418. https://doi.org/10.1016/S2215-0366(17)30015-9

    Article  PubMed  PubMed Central  Google Scholar 

  • Hazell P (2003) Depression in children and adolescents. Clin Evid 9:356–366

    Google Scholar 

  • Hazell P, Mirzaie M (2013) Tricyclic drugs for depression in children and adolescents. Cochrane Database Syst Rev (6):CD002317. https://doi.org/10.1002/14651858.CD002317.pub2

  • Hennissen L, Bakker MJ, Banaschewski T, Carucci S, Coghill D, Danckaerts M, Dittmann RW, Hollis C, Kovshoff H, McCarthy S, Nagy P, Sonuga-Barke E, Wong IC, Zuddas A, Rosenthal E, Buitelaar JK (2017) ADDUCE consortium. Cardiovascular effects of stimulant and non-stimulant medication for children and adolescents with ADHD: a systematic review and meta-analysis of trials of methylphenidate, amphetamines and atomoxetine. CNS Drugs 31(3):199–215. https://doi.org/10.1007/s40263-017-0410-7

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Henry A, Kisicki MD, Varley C (2012) Efficacy and safety of antidepressant drug treatment in children and adolescents. Mol Psychiatry 17(12):1186–1193. https://doi.org/10.1038/mp.2011.150. Epub 2011 Nov 8. Review

    Article  CAS  PubMed  Google Scholar 

  • Hodgkins P, Shaw M, Coghill D, Hechtmann L (2012) Amfetamine and methylphenidate medications for attention-deficit/hyperactivity disorder: complementary treatment options. Eur Child Adolesc Psychiatry 21:477–492

    Article  Google Scholar 

  • Issari Y, Jakubovski E, Bartley CA, Pittenger C, Bloch MH (2016) Early onset of response with selective serotonin reuptake inhibitors in obsessive-compulsive disorder: a meta-analysis. J Clin Psychiatry 77(5):e605–e611. https://doi.org/10.4088/JCP.14r09758

    Article  PubMed  Google Scholar 

  • Koelch M, Prestel A, Singer H, Fegert JM, Schlack R, Hoelling H, Knopf H (2009) Psychotropic medication in children and adolescents in germany: prevalence, indication and psychopathological patterns. J Child Adolesc Psychopharmacol 19(6):765–770

    Article  CAS  Google Scholar 

  • Koelch M, Pfalzer A, Kliegl K, Rothenhöfer S, Ludolph AG, Fegert JM, Burger R, Mehler-Wex C, Stingl J, Gerlach M. (2012) Therapeutic drug monitoring of children and adolescents using fluoxetine, Pharmacopsychiatry 45(2):72–76

    Article  CAS  Google Scholar 

  • Kölch M (2012) Aufklärung bei klinischen Prüfungen. In: Hinze, Gleiter, Meng (Hrsg) Klinische Arzneimittelprüfung: Angewandte GCP für Prüfärzte und Studienteams mit Multiple Choice Fragen, Checklisten und SOPs. Editio Cantor, Aulendorf

    Google Scholar 

  • Kölch M (2019) Stimulanzien in der Therapie einer ADHS sind schädlich für Wachstum und Knochendichte – Contra. Psychiatr Prax 46(1):10–11. https://doi.org/10.1055/a-0759-9659

    Article  Google Scholar 

  • Kölch M, Allroggen M, Fegert JM (2009) Off-label use von Psychopharmaka in der Kinder- und Jugendpsychiatrie – ein andauerndes ethisches, medizinisches und rechtliches Problem. Nervenarzt 80(7):789–796

    Article  Google Scholar 

  • Kölch M, Plener P, Ludolph A, Fegert JM (2010) Psychotrope Medikation bei Minderjährigen in Deutschland. Psychopharmakotherapie 17(3):112–118

    Google Scholar 

  • Locher C, Koechlin H, Zion SR, Werner C, Pine DS, Kirsch I, Kessler RC, Kossowsky J (2017) Efficacy and safety of selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and placebo for common psychiatric disorders among children and adolescents. JAMA Psychiat 74(10):1011–1020

    Article  Google Scholar 

  • Ludolph AG, Roessner V, Münchau A, Müller-Vahl K (2012) Tourette syndrome and other tic disorders in childhood, adolescence and adulthood. Dtsch Arztebl Int 109(48):821–288. https://doi.org/10.3238/arztebl.2012.0821

    Article  PubMed  PubMed Central  Google Scholar 

  • Maras A, Schroder CM, Malow BA, Findling RL, Breddy J, Nir T, Shahmoon S, Zisapel N, Gringras P (2018) Long-term efficacy and safety of pediatric prolonged-release melatonin for insomnia in children with autism spectrum disorder. J Child Adolesc Psychopharmacol 28(10):699–710

    Article  CAS  Google Scholar 

  • Pagsberg AK, Tarp S, Glintborg D, Stenstrom AD, Fink-Jensen A, Correll CU, Christensen R (2017) Acute antipsychotic treatment of children and adolescents with schizophrenia-spectrum disorders: a systematic review and network meta-analysis. J Am Acad Child Adolesc Psychiatry 56(3):191–202

    Article  Google Scholar 

  • Plener P, Gatz S, Schuetz C, Ludolph AG, Kölch M (2012a) A case of selective mutism in an 8-year-old girl with thalassaemia major after bone marrow transplantation. Pharmacopsychiatry 22:37–39

    Google Scholar 

  • Plener PL, Fegert JM, Kölch MG (2012b) Psychopharmakologische Behandlung von Depressionen im Kindes- und Jugendalter, Entwicklungen und Standards seit der „Black Box“ Warnung. Z Kinder Jugendpsychiatr Psychother 40(6):365–371

    Article  Google Scholar 

  • Ruggiero S, Clavenna A, Reale L, Capuano A, Rossi F, Bonati M (2014) Guanfacine for attention deficit and hyperactivity disorder in pediatrics: a systematic review and meta-analysis. Eur Neuropsychopharmacol 24(10):1578–1590. https://doi.org/10.1016/j.euroneuro.2014.08.001. Epub 2014 Aug 11

    Article  CAS  PubMed  Google Scholar 

  • Safer DJ, Zito JM (2006) Treatment-emergent adverse events from selective Serotonin reuptake inhibitors by age group: children versus adolescents. J Child Adolesc Psychopharmacol 16:159–169

    Article  Google Scholar 

  • Schepker R, Lippert HD, Kölch M, Fegert JM (2007) Fragwürdigkeit eines Gerichtsurteils zur Antidepressiva-Verordnung bei Jugendlichen Kommentar zum SSRI-Absetz-Urteil des SG Dresden und zunehmenden Eingriffen in die ärztliche Therapiefreiheit. Z Kinder Jugendpsychiatr Psychother 35(3):207–212

    Article  Google Scholar 

  • Schimmelmann BG, Schmidt SJ, Carbon M, Correll CU (2013) Treatment of adolescents with early-onset schizophrenia spectrum disorders: in search of a rational, evidence-informed approach. Curr Opin Psychiatry 26(2):219–230. https://doi.org/10.1097/YCO.0b013e32835dcc2

    Article  PubMed  Google Scholar 

  • Scholle O, Fegert JM, Kollhorst B, Öztürk E, Riedel O, Kölch M (2018) Interventions after first-time diagnosis of attention-deficit/hyperactivity disorder in children: a longitudinal population-based cohort study. J Atten Disord 6:1087054718816172. https://doi.org/10.1177/1087054718816172

    Article  Google Scholar 

  • Schwarz V, Reis O, Glaser T, Thome J, Hiemke C, Haessler F (2014) Therapeutic drug monitoring of zuclopenthixol in a double-blind placebo-controlled discontinuation study in adults with intellectual disabilities and aggressive behaviour. Pharmacopsychiatry 47(1):29–32. https://doi.org/10.1055/s-0033-1361115. Epub 2013 Dec 4

    Article  CAS  PubMed  Google Scholar 

  • Sharma T, Guski LS, Freund N, Gøtzsche PC (2016) Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports. BMJ 352:i65. https://doi.org/10.1136/bmj.i65

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Skapinakis P, Caldwell D, Hollingworth W, Bryden P, Fineberg N, Salkovskis P, Welton N, Baxter H, Kessler D, Churchill R, Lewis G (2016). A systematic review of the clinical effectiveness and cost-effectiveness of pharmacological and psychological interventions for the management of obsessive-compulsive disorder Health Technol Assess 20(43):1–392. https://doi.org/10.3310/hta20430

  • Solmi M, Murru A, Pacchiarotti I, Undurraga J, Veronese N, Fornaro M, Stubbs B, Monaco F, Vieta E, Seeman MV, Correll CU, Carvalho AF (2017) Safety, tolerability, and risks associated with first- and second-generation antipsychotics: a state-of-the-art clinical review. Ther Clin Risk Manag 13:757–777

    Article  CAS  Google Scholar 

  • Stafford MR, Mayo-Wilson E, Loucas CE, James A, Hollis C, Birchwood M, Kendall T (2015) Efficacy and safety of pharmacological and psychological interventions for the treatment of psychosis and schizophrenia in children, adolescents and young adults: a systematic review and meta-analysis. PLoS One 10(2):e0117166

    Article  Google Scholar 

  • Storch EA, Bussing R, Small BJ et al (2013) Randomized, placebo-controlled trial of cognitive-behavioral therapy alone or combined with sertraline in the treatment of pediatric obsessive-compulsive disorder. Behav Res Ther 51(12):823–829

    Article  Google Scholar 

  • Tohen M, Kryzhanovskaya L, Carlson G, Delbello M, Wozniak J, Kowatch R, Wagner K, Findling R, Lin D, Robertson-Plouch C, Xu W, Dittmann RW, Biederman J (2007) Olanzapine versus placebo in the treatment of adolescents with bipolar mania. Am J Psychiatry 164(10):1547–1556

    Article  Google Scholar 

  • Vries YA de, de Jonge P, Kalverdijk L, Bos JH, Schuiling-Veninga CC, Hak E (2016) Poor guideline adherence in the initiation of antidepressant treatment in children and adolescents in the Netherlands: choice of antidepressant and dose. Eur Child Adolesc Psychiatry 25(11):1161–1170

    Google Scholar 

  • Whittington C, Pennant M, Kendall T, Glazebrook C, Trayner P, Groom M, Hedderly T, Heyman I, Jackson G, Jackson S, Murphy T, Rickards H, Robertson M, Stern J, Hollis C (2016) Practitioner review: treatments for tourette syndrome in children and young people – a systematic review. J Child Psychol Psychiatry 57(9):988–1004

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael Kölch .

Editor information

Editors and Affiliations

Section Editor information

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Kölch, M. (2021). Psychopharmakologie in der Kinder- und Jugendpsychiatrie. In: Fegert, J., et al. Psychiatrie und Psychotherapie des Kindes- und Jugendalters. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49289-5_69-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-49289-5_69-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-49289-5

  • Online ISBN: 978-3-662-49289-5

  • eBook Packages: Springer Referenz Medizin

Publish with us

Policies and ethics