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Anxiolytics, adrenergic agents, and naltrexone.
J Am Acad Child Adolesc Psychiatry. 1999 May; 38(5):546-56.JA

Abstract

OBJECTIVE

To review extant data on the efficacy and safety of anxiolytic medications (benzodiazepines, buspirone, and other serotonin 1A agonists), adrenergic agents (beta-blockers and alpha 2-adrenergic agonists clonidine and guanfacine), and the opiate antagonist naltrexone that have been used to treat various psychopathologies in children and adolescents. To identify critical gaps in our current knowledge about these agents and needs for further research.

METHOD

All available controlled trials of these medications in children and adolescents published in English through 1997 were reviewed. In addition, selected uncontrolled studies are included.

RESULTS

The major finding, that there are virtually no controlled data that support the efficacy of most of these drugs for the treatment of psychiatric disorders in children and adolescents, is both surprising and unfortunate. For some drugs, e.g., buspirone and guanfacine, this is because no controlled studies have been carried out in children and/or adolescents. For other drugs, e.g., clonidine and naltrexone, most of the placebo-controlled studies have failed to demonstrate efficacy.

CONCLUSIONS

The strongest recommendations for controlled studies of safety and efficacy in children and adolescents can be given for the following drugs: benzodiazepines for acute anxiety; buspirone (and newer serotonin 1A agonists as they become available) for anxiety and depression; beta-blockers for aggressive dyscontrol; guanfacine for attention-deficit/hyperactivity disorder; and naltrexone for hyperactivity, inattention, and aggression in autistic disorder.

Authors+Show Affiliations

Division of Child and Adolescent Psychiatry, Johns Hopkins Medical Institutions, Baltimore, MD, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

10230186

Citation

Riddle, M A., et al. "Anxiolytics, Adrenergic Agents, and Naltrexone." Journal of the American Academy of Child and Adolescent Psychiatry, vol. 38, no. 5, 1999, pp. 546-56.
Riddle MA, Bernstein GA, Cook EH, et al. Anxiolytics, adrenergic agents, and naltrexone. J Am Acad Child Adolesc Psychiatry. 1999;38(5):546-56.
Riddle, M. A., Bernstein, G. A., Cook, E. H., Leonard, H. L., March, J. S., & Swanson, J. M. (1999). Anxiolytics, adrenergic agents, and naltrexone. Journal of the American Academy of Child and Adolescent Psychiatry, 38(5), 546-56.
Riddle MA, et al. Anxiolytics, Adrenergic Agents, and Naltrexone. J Am Acad Child Adolesc Psychiatry. 1999;38(5):546-56. PubMed PMID: 10230186.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anxiolytics, adrenergic agents, and naltrexone. AU - Riddle,M A, AU - Bernstein,G A, AU - Cook,E H, AU - Leonard,H L, AU - March,J S, AU - Swanson,J M, PY - 1999/5/7/pubmed PY - 1999/5/7/medline PY - 1999/5/7/entrez SP - 546 EP - 56 JF - Journal of the American Academy of Child and Adolescent Psychiatry JO - J Am Acad Child Adolesc Psychiatry VL - 38 IS - 5 N2 - OBJECTIVE: To review extant data on the efficacy and safety of anxiolytic medications (benzodiazepines, buspirone, and other serotonin 1A agonists), adrenergic agents (beta-blockers and alpha 2-adrenergic agonists clonidine and guanfacine), and the opiate antagonist naltrexone that have been used to treat various psychopathologies in children and adolescents. To identify critical gaps in our current knowledge about these agents and needs for further research. METHOD: All available controlled trials of these medications in children and adolescents published in English through 1997 were reviewed. In addition, selected uncontrolled studies are included. RESULTS: The major finding, that there are virtually no controlled data that support the efficacy of most of these drugs for the treatment of psychiatric disorders in children and adolescents, is both surprising and unfortunate. For some drugs, e.g., buspirone and guanfacine, this is because no controlled studies have been carried out in children and/or adolescents. For other drugs, e.g., clonidine and naltrexone, most of the placebo-controlled studies have failed to demonstrate efficacy. CONCLUSIONS: The strongest recommendations for controlled studies of safety and efficacy in children and adolescents can be given for the following drugs: benzodiazepines for acute anxiety; buspirone (and newer serotonin 1A agonists as they become available) for anxiety and depression; beta-blockers for aggressive dyscontrol; guanfacine for attention-deficit/hyperactivity disorder; and naltrexone for hyperactivity, inattention, and aggression in autistic disorder. SN - 0890-8567 UR - https://www.unboundmedicine.com/medline/citation/10230186/Anxiolytics_adrenergic_agents_and_naltrexone_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0890-8567(09)63136-1 DB - PRIME DP - Unbound Medicine ER -