Journal of child and adolescent psychopharmacology最新文献

{"title":"The Safety and Clinical Effects of Amisulpride in Children and Adolescents with Psychiatric Disorders: A Case Series.","authors":"Osman Özdemir","doi":"10.1089/cap.2024.0139","DOIUrl":"10.1089/cap.2024.0139","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> The objective of this study was to explore the safety and clinical effects of amisulpride in children and adolescents with psychiatric disorders. <b><i>Methods:</i></b> This case series included six patients, aged 11 to 19 years, diagnosed with affective disorder, autism, anxiety, psychosis, and obsessive-compulsive disorder, and treated with amisulpride at doses ranging from 100 to 400 mg per day. <b><i>Results:</i></b> Amisulpride appeared to reduce psychotic and behavioral symptoms. Observed side effects included increased appetite, weight gain, sedation, and mild extrapyramidal symptoms. <b><i>Conclusion:</i></b> Amisulpride may have promise for study and future use in children and adolescents with psychiatric disorders and severe symptoms.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"312-315"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifestyle Effects in a Randomized Controlled Trial of Neurofeedback for Attention-Deficit/Hyperactivity Disorder.","authors":"L Eugene Arnold, Kyle Hendrix, Xueliang Pan, Madelon A Vollebregt, Mengda Yu, Cynthia Kerson, Martijn Arns, Irene E Hatsu, Roger DeBeus, Jill Hollway, Michelle E Roley-Roberts","doi":"10.1089/cap.2025.0019","DOIUrl":"https://doi.org/10.1089/cap.2025.0019","url":null,"abstract":"<p><p><b><i>Objectives/Background:</i></b> Multiple factors influence symptom severity in Attention Deficit/Hyperactivity Disorder (ADHD). We examined four of these: diet, sleep hygiene, exercise, and lighting, in the International Collaborative ADHD Neurofeedback (ICAN) randomized clinical trial, which found large significant improvement with both active neurofeedback and control condition without treatment difference. <b><i>Methods:</i></b> A total of 142 participants aged 7-10 had breakfast and lunch intake and exercise recorded at each neurofeedback session. Parents completed the Children's Sleep Habits Questionnaire (CSHQ). Parents and teachers rated inattention on Conners3. Lifestyle changes were correlated with inattention changes. <b><i>Results:</i></b> At baseline, CSHQ correlated with parent-rated inattention (<i>r</i> = 0.17, <i>p</i> = 0.04), and length of sleep correlated with teacher-rated inattention (<i>r</i> = 0.20, <i>p</i> = 0.03). From baseline to treatment end food group variety (<i>p</i> = 0.029, <i>d</i> = 0.22) and sleep problems (<i>p</i> < 0.0001, d = -0.49) improved significantly, exercise time and protein intake marginally (<i>p</i> = 0.06 - 0.08). Parent-rated inattention improvement correlated with CSHQ improvement (Rho = 0.26, <i>p</i> = 0.002) and marginally with protein intake increase (Rho = 0.18, <i>p</i> = 0.06). The three components of the light-emitting-diode (LED)-induced circadian pathway hypothesis were significant. <b><i>Conclusions:</i></b> Most measures improved, but few significantly. How much they impact classroom attention remains unclear. Although parent ratings of inattention improvement correlated with sleep problems improvement, composited parent/teacher ratings (primary outcome) did not. The circadian pathway hypothesis associated with LED lighting was supported. These findings warrant further studies examining the role sleep hygiene can play in improving ADHD symptoms. Meanwhile, attention to sleep hygiene seems appropriate in any treatment plan for ADHD.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Brexpiprazole in the Treatment of Irritability Associated with Autism Spectrum Disorder: An 8-Week, Phase 3, Randomized, Double-Blind, Placebo-Controlled Trial and 26-Week Open-Label Extension in Children and Adolescents.","authors":"Caroline Ward, Ann Childress, Krista Martinko, Dalei Chen, Klaus Groes Larsen, Alpesh Shah, Pamela Sheridan, Nanco Hefting, James Knutson","doi":"10.1089/cap.2024.0118","DOIUrl":"10.1089/cap.2024.0118","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The effective management of irritability is a key need in young people with autism spectrum disorder (ASD). We evaluated the efficacy and safety of brexpiprazole in children and adolescents with irritability associated with ASD. <b><i>Methods:</i></b> This was an 8-week, phase 3, randomized, double-blind, placebo-controlled trial (NCT04174365) and 26-week, open-label extension (OLE, NCT04258839) of brexpiprazole (0.25-3 mg/day based on body weight) in children and adolescents (5-17 years) with a diagnosis of ASD, score ≥18 on the Aberrant Behavior Checklist-Irritability (ABC-I) subscale, and score ≥4 on the Clinical Global Impressions-Severity scale. <b><i>Results:</i></b> Of the 119 randomized participants (brexpiprazole = 60, placebo = 59), 104 completed double-blind treatment, and 95 enrolled and 70 completed the OLE. Similar reductions in mean ABC-I subscale score were seen in both groups (least-squares mean ± standard error reduction from double-blind baseline of -10.1 ± 1.3 with brexpiprazole vs -8.9 ± 1.3 with placebo). Thus, the primary endpoint did not show a significant treatment effect (LS-mean [95% confidence interval] treatment difference: -1.22 [-4.49, 2.05], <i>p</i> = 0.46) and the hierarchical efficacy analysis ended at this point. At the end of the OLE, participants had a mean ± SD reduction from open-label baseline of -6.1 ± 8.2 in ABC-I subscale score. During double-blind treatment, 51.7% participants treated with brexpiprazole had ≥1 treatment-emergent adverse event (TEAE) versus 35.1% with placebo; no severe or serious TEAEs were reported. The only potentially treatment-related TEAE that occurred in ≥5% of participants was somnolence (12.1% for brexpiprazole vs 5.3% for placebo). During the OLE, the most commonly reported TEAE was increased weight (<i>n</i> = 13, 13.7%). <b><i>Conclusions:</i></b> Treatment with brexpiprazole did not demonstrate significant efficacy versus placebo for the treatment of irritability associated with ASD. The safety profile was consistent with that observed in adult and adolescent patients with schizophrenia.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"194-201"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Blueprint for Translational Precision Medicine in Autism Spectrum Disorder and Related Neurogenetic Syndromes.","authors":"Robyn P Thom, Tracy L Warren, Suha Khan, Rebecca A Muhle, Paul P Wang, Kristen Brennand, Nicole R Zürcher, Jeremy Veenstra-VanderWeele, Ellen J Hoffman","doi":"10.1089/cap.2025.0023","DOIUrl":"10.1089/cap.2025.0023","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> Despite growing knowledge of the underlying neurobiology of autism spectrum disorder (ASD) and related neurogenetic syndromes, treatment discovery has remained elusive. In this review, we provide a blueprint for translational precision medicine in ASD and related neurogenetic syndromes. <b><i>Methods:</i></b> The discovery of trofinetide for Rett syndrome (RTT) is described, and the role of nonmammalian, mammalian, and stem cell model systems in the identification of molecular targets and drug screening is discussed. We then provide a framework for translating preclinical findings to human clinical trials, including the role of biomarkers in selecting molecular targets and evaluating target engagement, and discuss how to leverage these findings for future ASD drug development. <b><i>Results:</i></b> Multiple preclinical model systems for ASD have been developed, each with tradeoffs with regard to suitability for high-throughput small molecule screening, conservation across species, and behavioral face validity. Future clinical trials should incorporate biomarkers and intermediate phenotypes to demonstrate target engagement. Factors that contributed to the approval of trofinetide for RTT included replicated findings in mouse models, a well-studied natural history of the syndrome, development of RTT-specific outcome measures, and strong engagement of the RTT family community. <b><i>Conclusions:</i></b> The translation of our growing understanding of the neurobiology of ASD to human drug discovery will require a precision medicine approach, including the use of multiple model systems for molecular target selection, evaluation of target engagement, and clinical trial design strategies that address heterogeneity, power, and the placebo response.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"178-193"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Probing the Neurodynamic Mechanisms of Cognitive Flexibility in Depressed Individuals with Autism Spectrum Disorder.","authors":"Rana Elmaghraby, Elizabeth Blank, Makoto Miyakoshi, Donald L Gilbert, Steve W Wu, Travis Larsh, Grace Westerkamp, Yanchen Liu, Paul S Horn, Craig A Erickson, Ernest V Pedapati","doi":"10.1089/cap.2024.0109","DOIUrl":"10.1089/cap.2024.0109","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Autism spectrum disorder (ASD) is characterized by deficits in social behavior and executive function (EF), particularly in cognitive flexibility. Whether transcranial magnetic stimulation (TMS) can improve cognitive outcomes in patients with ASD remains an open question. We examined the acute effects of prefrontal TMS on cortical excitability and fluid cognition in individuals with ASD who underwent TMS for refractory major depression. <b><i>Methods:</i></b> We analyzed data from an open-label pilot study involving nine participants with ASD and treatment-resistant depression who received 30 sessions of accelerated theta burst stimulation of the dorsolateral prefrontal cortex, either unilaterally or bilaterally. Electroencephalography data were collected at baseline and 1, 4, and 12-weeks posttreatment and analyzed using a mixed-effects linear model to assess changes in regional cortical excitability using three models of spectral parametrization. Fluid cognition was measured using the National Institutes of Health Toolbox Cognitive Battery. <b><i>Results:</i></b> Prefrontal TMS led to a decrease in prefrontal cortical excitability and an increase in right temporoparietal excitability, as measured using spectral exponent analysis. This was associated with a significant improvement in the NIH Toolbox Fluid Cognition Composite score and the Dimensional Change Card Sort subtest from baseline to 12 weeks posttreatment (t = 3.79, p = 0.005, <i>n</i> = 9). Improvement in depressive symptomatology was significant (HDRS-17, F (3, 21) = 28.49, <i>p</i> < 0.001) and there was a significant correlation between cognitive improvement at week 4 and improvement in depression at week 12 (r = 0.71, <i>p</i> = 0.05). <b><i>Conclusion:</i></b> These findings link reduced prefrontal excitability in patients with ASD and improvements in cognitive flexibility. The degree to which these mechanisms can be generalized to ASD populations without Major Depressive Disorder remains a compelling question for future research.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"231-243"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Curious Case of Therapist Self-Disclosure During Pharmacotherapy Visits in an Autism Center.","authors":"Sarah Daniella Kevelson","doi":"10.1089/cap.2024.0149","DOIUrl":"10.1089/cap.2024.0149","url":null,"abstract":"","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"175-177"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychotropic Medication Prescription Patterns in Down Syndrome in a Large Pediatric Specialty Clinic.","authors":"Sarah Weas, Katherine Pawlowski, Miranda Miller, Rafael DePillis, Nicole Baumer","doi":"10.1089/cap.2024.0028","DOIUrl":"10.1089/cap.2024.0028","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> Patterns of psychotropic medication use in children and adolescents with Down syndrome (DS) are largely unknown. Clinical decisions are often made from evidence and experience from individuals with autism spectrum disorder (ASD) or intellectual disability (ID). <b><i>Methods:</i></b> Longitudinal data from 670 children with DS who received care in a specialty DS clinic from March 2021 to February 2024 were collected. After each clinic visit, the clinician indicated the presence or absence of co-occurring neurodevelopmental (ND) or mental health (MH) diagnoses, as well as whether the individual was prescribed a psychopharmacological treatment. We used descriptive statistics and analyzed associations between psychotropic medication use, co-occurring ND/MH conditions, and demographic data. <b><i>Results:</i></b> 19.1% of patients were prescribed at least one psychotropic medication at their most recent clinical visit. Alpha-agonists were the most commonly prescribed medication class (30.8%), followed by stimulants (18.9%), and antidepressants (16.7%). There was a significant difference in psychotropic medication use by age, with older children having increased odds of being prescribed a psychotropic medication. There were no differences in psychotropic medication use across sex (<i>p</i> = 0.10), race (<i>p</i> = 0.10), or household income (<i>p</i> = 0.16). <b><i>Conclusions:</i></b> We found that one-fifth of patients with DS were prescribed psychotropic medications. Nearly every individual with DS who was prescribed a psychotropic medication had a co-occurring ND/MH condition, yet these rates were lower than what have been reported in children with ID, ASD, and attention deficit/hyperactivity disorder. Further research needs to include those with DS to further understand medication efficacy and safe dosing practices to ensure optimal outcomes.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"249-254"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141537955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Letter:</i> Mirtazapine-Associated Hyperkinetic Movements in a 17-Year-Old with Autism Spectrum Disorder and Chronic Catatonia: A Case Report.","authors":"Leigh Berman, Ijeoma Onyema, Ewa Bieber","doi":"10.1089/cap.2024.0098","DOIUrl":"10.1089/cap.2024.0098","url":null,"abstract":"","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"255-256"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Prospective Open-Label Trial of Buspirone for the Treatment of Anxiety in Williams Syndrome.","authors":"Robyn P Thom, Danielle Renzi, Meredith Pecukonis, Jennifer Mullett, Caitlin Ravichandran, Christopher J McDougle","doi":"10.1089/cap.2024.0124","DOIUrl":"10.1089/cap.2024.0124","url":null,"abstract":"<p><p><b><i>Study Design:</i></b> Prospective open-label trial. <b><i>Objectives:</i></b> The objective of this study was to determine whether buspirone showed preliminary evidence of effectiveness, safety, and tolerability in individuals with Williams syndrome (WS). <b><i>Methods:</i></b> This is a 16-week, prospective, flexibly dosed, open-label trial of buspirone in 20 individuals with WS aged 5-65 years. The primary outcome measure was the Pediatric Anxiety Rating Scale (PARS). <b><i>Results:</i></b> Buspirone use (mean dose, 22.6 mg per day) was associated with a reduction in anxiety severity, with Cohen's <i>d</i> estimate of -4.02 for the PARS. All 18 participants who completed the study received the Clinical Global Impression-Improvement subscale score for anxiety of \"much improved\" or \"very much improved.\" No serious or severe adverse events occurred during the trial, and no participants discontinued the study due to adverse events. <b><i>Conclusion:</i></b> Buspirone was safe and well tolerated. It was also associated with a reduction in anxiety severity. Given these findings, a double-blind, placebo-controlled study of buspirone in WS is warranted.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"222-230"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142836630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Placebo Response in the Study of Oxytocin in Autism to Improve Reciprocal Social Behaviors.","authors":"Alyssa Verdes, Suvekcha Bhattachan, Alexander Kolevzon, Bryan H King, Christopher J McDougle, Kevin B Sanders, Soo-Jeong Kim, Marina Spanos, Tara Chandrasekhar, Carol Rockhill, Michelle Palumbo, Mendy Minjarez, Lisa Nowinski, Sarah Marler, Stephen Siecinski, Stephanie Giamberardino, Simon G Gregory, Jeremy Veenstra-VanderWeele, Linmarie Sikich, Amandeep Jutla","doi":"10.1089/cap.2024.0131","DOIUrl":"10.1089/cap.2024.0131","url":null,"abstract":"<p><p><b><i>Background:</i></b> Although randomized clinical trials (RCTs) have investigated several treatments for social communication difficulties and repetitive behavior in autism, none has yet shown consistent superiority over placebo. Placebo response in autism RCTs may impede the ability to detect meaningful treatment effects. <b><i>Objective:</i></b> We sought to identify individual-level predictors of placebo response in Study of Oxytocin in Autism to improve Reciprocal Social Behaviors (SOARS-B), a 24-week RCT of intranasal oxytocin for social impairment in autistic youth. In our primary analysis, we examined predictors of change in the Aberrant Behavior Checklist-modified Social Withdrawal (ABC-mSW) score at 24 weeks in SOARS-B participants taking placebo. Secondary analyses examined predictors of ABC-mSW change at 12 weeks and of Clinical Global Impressions-Improvement at 24 and 12 weeks. We also examined predictors of response among SOARS-B participants taking oxytocin. <b><i>Methods:</i></b> For each analysis, we first used lasso (least absolute shrinkage and selection operator) regression to identify potentially influential predictors from a large group that included demographic factors, rating scale data, and prescribed medications. We then estimated an unpenalized linear regression model for the outcome of interest that included only variables retained by the optimal lasso. We considered variables with statistically significant coefficients to be influential predictors. <b><i>Results:</i></b> Higher baseline ABC-mSW score was the only significant predictor of greater ABC-mSW change in the placebo group at 24 and 12 weeks. <b><i>Conclusions:</i></b> In SOARS-B, higher baseline severity on a measure of reciprocal social communication predicted greater placebo response. This is consistent with the finding that lower social communication adaptive functioning was associated with greater placebo response in recent RCTs of balovaptan for social impairment in autism. However, it contrasts with findings from a trial of citalopram for repetitive behavior in autism, in which lower baseline severity of a composite of autistic and mood symptoms predicted greater placebo response. This may indicate that different factors contribute to placebo response in different symptom domains.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"202-210"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}