Dr. Peter Jensen, a Mayo Clinic psychiatrist who led the development of the new guidelines, said anti-psychotics and mood-stabilizing drugs are increasingly prescribed to children on an outpatient basis to treat overt aggression, a symptom that may have multiple causes.
"These large-scale shifts in treatment practices have occurred despite potentially troubling side effects and a lack of supportive empirical evidence," Jensen said in a statement. "With the increase in the prescription of psychotropic agents outside of Food and Drug Administration-approved indications, concerns have been raised over treatment decision-making, appropriate use of alternative therapies, long-term management and safety of multiple drug regimens."
The Mayo Clinic, The REACH Institute, the Center for Education and Research on Mental Health Therapeutics at Rutgers University and 60 national experts joined to achieve consensus on improving the diagnosis and treatment of aggressive children and adolescents.
The guidance, published in Pediatrics, included: Engaging and forming a strong treatment alliance with the patient and family; conducting a thorough diagnostic workup; measuring treatment response and outcomes using reliable assessment tools; providing education and support for families; helping families obtain community and educational resources; using proven psychological therapies before starting any anti-psychotic or mood stabilizer medications; and tracking and preventing, whenever possible, side effects.