The use of psychopharmacologic interventions for children with post-traumatic stress disorder (PTSD) and other trauma-related conditions is becoming increasingly widespread despite little empirical evidence that supports this trend. This article reviews the current research concerning the efficacy of psychotropic medications for childhood PTSD and discusses the clinical, research, and policy implications of this literature.
Ambrosini, P. J.
, Wagner, K. D., Biederman, J., Glick, I., Tan, C., Elia, J., Hebeler, J. R., Rabinovich, H., Lovk, J., & Geller, D. (1999). Multicenter open-label Sertraline study in adolescent outpatients with major depression. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 566-572.
2.
American Academy of Child and Adolescent Psychiatry
. (1998). Practice parameters for the assessment and treatment of children and adolescents with posttraumatic stress disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 37(Suppl.), S4-S26.
3.
American Psychiatric Association
. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
4.
Angold, A.
, Erkanli, A., Egger, H. L., & Costello, E. J. (2000). Stimulant treatment for children: A community perspective. Journal of the Academy of Child and Adolescent Psychiatry, 39, 975-984.
5.
Birmaher, B.
, Ryan, N. D., Brent, D. B., Williamson, D. E., & Kaufman, J. (1996). Child and adolescent depression: A review of the last 10 years. Part II. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 1575-1583.
6.
Black, B.
, & Uhde, T. W. (1994). Treatment of elective mutism with fluoxetine: A double-blind placebocontrolled study. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 1000-1006.
7.
Boney-McCoy, A.
, & Finkelhor, D. (1996). Is youth victimization related to trauma symptoms and depression after controlling for prior symptoms and family relationships?Journal of Consulting and Clinical Psychology, 64, 1406-1416.
8.
Brady, K.
, Pearlstein, T., Asnis, G. M., Bake, D., Rothbaum, B., Sikes, C. R., & Farfel, G. M. (2000). Efficacy and safety of Sertraline treatment of PTSD: A randomized controlled trial. Journal of the American Medical Association, 283, 1837-1844.
9.
Braun, P.
, Greenberg, D., Dasberg, H., & Lerer, B. (1990). Core symptoms of PTSD unimproved by alprazolam treatment. Journal of Clinical Psychiatry, 51, 236-238.
10.
Cohen, J. A.
, Berliner, L., & March, J. S. (2000). Guidelines for treatment of PTSD: Treatment of children and adolescents. Journal of Traumatic Stress, 13, 566-568.
11.
Cohen, J. A.
, & Mannarino, A. P. (1996). A treatment outcome study of sexually abused preschool children: Initial findings. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 1402-1410.
12.
Cohen, J. A.
, & Mannarino, A. P. (1998). Interventions for sexually abused children: Initial treatment findings. Child Maltreatment, 3, 53-62.
13.
Cohen, J. A.
, Mannarino, A. P., & Rogal, S. S. (2001). Treatment practices for childhood PTSD. Child Abuse and Neglect, 25, 123-125.
14.
Davidson, J. R.
, Rothbaum, B. O., van der Kolk, B. A., Sikes, C. R., & Farfel, G. M. (1998, November). Multi-center, double-blind comparison of sertraline and placebo in the treatment of posttraumatic stress disorder. Paper presented at the International Society for Traumatic Stress Studies, Washington, DC.
15.
DeBellis, M. D.
(1997). Posttraumatic stress disorder and acute stress disorder. In R. T. Ammerman & M. Hersen (Eds.), Handbook of prevention and treatment with children and adolescents: Intervention in the real world context (pp. 455-494). New York: Plenum.
16.
DeBellis, M. D.
, Lefter, L., Trickett, P. K., & Putnam, F. W. (1994). Urinary catecholamine excretion in sexually abused girls. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 320-327.
17.
Deblinger, E.
, Lippmann, J., & Steer, R. (1996). Sexually abused children suffering posttraumatic stress symptoms: Initial treatment outcome findings. Child Maltreatment, 1, 310-321.
18.
Domon, S. E.
, & Andersen, M. S. (2000). Nefazodone for PTSD [Letter]. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 942-943.
19.
Donnelly, C.
, Amaya-Jackson, L., & March, J. S. (1999). Psychopharmacology of pediatric posttraumatic stress disorder. Journal of Child and Adolescent Psychopharmacology, 9, 203-220.
20.
Donovan, S. J.
, Stewart, J. W., Nunes, E. V., Quitkin, F. M., Parides, M., Daniel, W., Susser, E., & Klein, D. F. (2000). Divalproex treatment for youth with explosive temper and mood lability: A double-blind, placebo-controlled crossover study. American Journal of Psychiatry, 157, 818-820.
21.
Famularo, R.
, Kinscherff, R., & Fenton, T. (1988). Propranolol treatment for childhood posttraumatic stress disorder, acute type: A pilot study. American Journal on Disabled Children, 142, 1244-1247.
22.
Findling, R. L.
, Preskorn, S. H., Marcus, R. N., Magnus, R. D., D'Amico, F., Marathe, P., & Reed, M. D. (2000). Nefazodone pharmacokinetics in depressed children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 1008-1016.
23.
Foa, E. B., Davidson, R. T., & Frances, A. (Eds.). (1999). Expert consensus guideline series: Treatment of posttraumatic stress disorder [Special issue]. Journal of Clinical Psychiatry, 69(16).
24.
Ford, J. D.
, Racusin, R., Daviss, W. B., Elis, C. G., & Thomas. J. (1999). Trauma exposure among children with oppositional defiant disorder and attention deficit hyperactivity disorder. Journal of Consulting and Clinical Psychology, 67, 786-789.
25.
Frederick, C. H.
(1985). Children traumatized by catastrophic situations. In S. Eth & R. S. Pynoos (Eds.), Posttraumatic stress disorder in children (pp. 71-100). Washington, DC: American Psychiatric Press.
26.
Friedman, M. J.
(1990). Interrelationships between biological mechanisms and pharmacotherapy of posttraumatic stress disorder. In M. E. Wolfe & A. D. Mosnian (Eds.), Post-traumatic stress disorder: Etiology, phenomenology, and treatment (pp. 204-225). Washington, DC: American Psychiatric Press.
27.
Friedman, M. J.
(1998). Current and future drug treatment for posttraumatic stress disorder patients. Psychiatric Annals, 28, 461-468.
28.
Friedman, M. J.
, Davidson, J.R.T., Mellman, T. A., & Southwick, S. M. (2000). Pharmacotherapy. In E. B. Foa, T. M. Keane, & M. J. Friedman (Eds.), Effective treatment for PTSD (pp. 84-105). New York: Guilford.
29.
Friedman, M. J.
, & Southwick, S. M. (2000). Towards pharmacotherapy for posttraumatic stress disorder. In M. J. Friedman, D. S. Charney, & Y. A. Deutch (Eds.), Neurobiological and clinical consequences of stress: From normal adaptation to PTSD (pp. 465-481). Philadelphia: J. B. Lippincott.
30.
Glover, H.
(1992). Emotional numbing: A possible endorphin-medicated phenomenon associated with post-traumatic stress disorder and other allied psychopathological states. Journal of Traumatic Stress, 5, 643-675.
31.
Goenjian, A. K.
, Karayan, I., Pynoos, R. S., Minassian, D., Najarian, L. M., Stinber, A. M., & Faribanks, L. A. (1997). Outcome of psychotherapy among early adolescents after trauma. American Journal of Psychiatry, 154, 536-542.
32.
Harmon, R. J.
, & Riggs, P. D. (1996). Clinical perspectives: Clonidine for posttraumatic stress disorder in preschool children. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 1247-1249.
33.
Hertzberg, M.
, Feldman, M., Beckham, J. C., Moore, S., & Davidson, T. (1998). Open trial of nefazodone for combatrelated PTSD. Journal of Clinical Psychiatry, 59, 460-464.
34.
Horrigan, J. P.
(1996). Guanfacine for posttraumatic stress disorder [Letter]. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 975-976.
35.
Horrigan, J. P.
, & Barnhill, L. J. (1999). Risperidone and PTSD in boys. Journal of Neuropsychiatry and Clinical Neurosciences, 11, 126-127.
36.
Jensen, P.
, Greenhill, L., & Abikoff, H. (2000, October). Research forum: Optimal strategies for developing and implementing psychopharmacologic studies in preschool children. Paper presented at the 47th annual meeting of the American Academy of Child and Adolescent Psychiatry, New York.
37.
Johnson, K. M.
, Foa, E. B., Jaycox, L. H., & Reconda, L. (1996, November). A self-report diagnostic instrument for children with PTSD. Paper presented at the 12th Annual Meeting of the International Society for Traumatic Stress Studies, San Francisco.
38.
Kazdin, A.
(1995). Scope of child and adolescent psychotherapy research: Limited sampling of dysfunctions, treatments, and client characteristics. Journal of Clinical Child Psychology, 61, 235-247.
39.
Kinzie, J. D.
, & Leung, P. (1989). Clonidine in Cambodian patients with posttraumatic stress disorder. Journal of Nervous and Mental Disease, 177, 546-550.
40.
Kolb, L. C.
, Burris, B. C., & Griffiths, S. (1984). Propranolol and clonidine in the treatment of the chronic posttraumatic stress disorders of war. In B. A. van der Kolk (Ed.), Posttraumatic stress disorder: Psychological and biological sequelae (pp. 97-107). Washington, DC: American Psychiatric Press.
41.
Kolko, D.
(1996). Individual cognitive-behavioral treatment and family therapy for physically abused children and their offending parents: A comparison of clinical outcomes. Child Maltreatment, 1, 322-342.
42.
Kowatch, R. A.
, Suppes, T., Carmody, T. J., Bucci, J. P., Hume, J. H., Kromelis, M., Emslie, G. J., Weinberg, W. A., & Rush, A. J. (2000). Effect size of lithium, divalproex sodium, and carbamazepine in children and adolescents with bipolar disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 713-720.
43.
Leber, P.
(2000). Placebo controls. Archives of General Psychiatry, 57, 319-320.
44.
Leon, A. C.
(2000). Placebo protects subjects from nonresponse: A paradox of power. Archives of General Psychiatry, 57, 329-330.
45.
Lipper, S.
, Davidson, J.R.T., Grady, T. A., Edingar, J. D., Hammett, E. B., Mahorney, S. L., & Cavenar, J. O. (1986). Preliminary study of carbamazepine in post-traumatic stress disorder. Psychosomatics, 27, 849-854.
46.
Looff, D.
, Grimley, P., Kuiler, F., Martin, A., & Shonfield, L. (1995). Carbamazepine for PTSD [Letter]. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 703-704.
47.
March, J. S.
, Amaya-Jackson, L., Murray, M. C., & Schulte, A. (1998). Cognitive-behavioral psychotherapy for children and adolescents with PTSD after a single incident stressor. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 585-593.
48.
March, J. S.
, Biederman, J., Wolkow, R., Safferman, A., Mardekian, J., Cook, E. H., Cutler, N. R., Dominguez, R., Ferguson, J., Muller, B., Riesenberg, R., Rosenthal, M., Sallee, F. R., & Wagner, K. D. (1998). Sertraline in children and adolescents with OCD: A multicenter doubleblind placebo controlled study. Journal of the American Medical Association, 280, 1752-1756.
49.
McLeer, S. V.
, Callaghan, M., Henry, D., & Wallen, J. (1994). Psychiatric disorders in sexually abused children. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 313-319.
50.
Metchcatie, E.
(2000, April). Pediatric labeling of psychiatric drugs to improve: Federal law provides financial incentive. Clinical Psychiatry News, 30-31.
51.
Michels, K. B.
(2000). The placebo problem remains. Archives of General Psychiatry, 57, 321-322.
52.
Morgan, G. A.
, Gliner, J. A., & Harmon, R. J. (2000). Randomized experimental designs. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 1062-1064.
53.
MTA Cooperative Group
. (1999). A 14-month randomized clinical trial of treatment strategies for ADHD: The MTA study of children with ADHD. Archives of General Psychiatry, 56, 1088-1096.
54.
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. 223-255). Washington, DC: American Psychiatric Press.
55.
Quitkin, F. M.
, & Klein, D. F. (2000). What conditions are necessary to assess antidepressant efficacy?Archives of General Psychiatry, 87, 323-324.
56.
Reynolds, W. M.
, & Coates, K. L. (1986). A comparison of cognitive-behavioral therapy and relaxation training for the treatment of depression in adolescents. Journal of Consulting and Clinical Psychology, 54, 653-660.
57.
Riddle, M. A.
, Schahill, L. S., King, R. A., Hardin, M. T., Anderson, G. M., Ort, S. I., Smith, J. C., Leckman, J. F., & Cohen, D. J. (1992). Double-blind cross-over trial of fluoxetine and placebo in children and adolescents with OCD. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 1062-1069.
58.
Singer, M. I.
, Anglin, T., Song, L., & Lunghofer, L. (1995). Adolescents' exposure to violence and associated symptoms of psychological trauma. Journal of the American Medical Association, 273, 477-482.
59.
Southwick, S. M.
, Krystal, J. H., Bremner, J. D., Morgan, C. A., Nicolaou, A. L., Nagy, L. M., Johnson, D. R., Heninger, G. R., & Charney, D. S. (1997). Noradrenergic and serotonergic function in PTSD. Archives of General Psychiatry, 54, 749-758.
60.
Trupin, E.
, Tarico, V., & Low, B. (1993). Children on child protective service caseloads: Prevalence and nature of serious emotional disturbance. Child Abuse and Neglect, 17, 345-355.
61.
Vitiello, B.
, Bhaatara, V. S., & Jensen, P. S. (1999). Current knowledge and unmet needs in pediatric psychopharmacology. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 501-503.
62.
Zito, J. M.
, Safer, D. J., dosReis, S., Magder, L. S., Gardner, J. F., & Zarin, D. A. (1999). Psychotherapeutic medication problems for youth with attention deficit/hyperactivity disorder. Archives of Pediatric and Adolescent Medicine, 153, 1257-1263.
