On 7 December 2023, the Lancet Psychiatry Journal published its position paper on Psychopharmacology in children and adolescents: unmet needs and opportunities, addressing the current landscape of pharmacological treatments as well as the way to pave forward. The paper addresses challenges in clinical studies, regulatory frameworks, and research innovations. Key issues include limited evidence in child and adolescent pharmacotherapy, developmental impacts, and integrating patient and caregiver perspectives. It also discusses future directions for clinical trials, and potential new medications, and emphasizes understanding long-term effects on the developing brain.
Current Challenges and Unmet Needs: The scarcity of comprehensive evidence supporting the efficacy and safety of many psychiatric medications in young populations is a persistent challenge; it underscores the need for more developmentally appropriate treatments and highlights the risks associated with “off-label” prescribing.
Evidence for Current Medications: The paper extensively reviewed existing medications used in treating mental health disorders in children and adolescents, taking into consideration the input from patient organisations, including GAMIAN-Europe, and experts by experience. It was highlighted that patients would like to be informed about the safety and tolerability whilst being able to evaluate the comparative effects of pharmacological and non-pharmacological interventions.
Future Clinical Studies and Research: The position paper offers clear suggestions for future research and clinical trials, regarding the placebo effects and in general the use of placebo in trials, the comparison between pharmacological and nonpharmacological interventions, the expansion of approaches examined, and the inclusion of patient-reported outcome measures. It also explores the potential for new therapeutic options, including cutting-edge treatments and personalized medicine approaches.
Regulatory and Legislative Frameworks: The current regulatory landscape governing the use of psychiatric medications in younger populations should be reformed and improved to ensure that safer and more effective treatments are available.
Integrating Patient and Caregiver Perspectives: The paper emphasizes the importance of considering the experiences and preferences of patients and their caregivers in treatment decisions. It suggests ways to include their perspectives in clinical practice and research. This is crucial to reducing stigma, not only to children and their caregivers but also to school personnel.
Among other patient organisations, GAMIAN-Europe was consulted to share the patient’s input in psychopharmacology. This underlines the significance of incorporating the voices and experiences of patients in developing effective treatment strategies, reinforcing the belief that patient-centric approaches are pivotal in advancing mental health care.
Full access to the position paper here.