Psychotropic Medications and Their Effect on Brain Volumes in Childhood Psychopathology.

Abstract

The heightened awareness of psychopathology in childhood has been paralleled by an upsurge of prescriptions for psychotropic medications in this population (Olfson, Blanco, Liu, Wang, & Correll, 2012). Although medications are evidence-based treatments which in many disorders effectively ameliorate symptoms and impairment, their mounting use in pediatrics has been controversial (Rapoport, 2013). This is based on the lack of adequately powered randomized controlled trials combined with concerns for children’s greater sensitivity to side effects of psychotropic agents and the unclear ramifi cations for the developing brain. Physicians treating pediatric populations are thus charged with the challenge of weighing potentially far-reaching risks of medications against their benefi ts in children struggling with impairments that in and of themselves stand to impede development. To exercise sound clinical judgment, physicians should be informed about the neurobiological mechanisms and effects of psychotropic medications on the brain, particularly in children and adolescents. Advances in neuroimaging methods have provided the opportunity to begin to investigate the neural correlates of psychopathology as well as the impact of treatments on brain development. To examine the question of how pediatric psycho-