Clinical Handbook of Psychotropic Drugs for Children and Adolescents, 4th edition

Andrew Veysey, BSc, BScPharm

Elbe D, Black TR, McGrane IR, Procyshyn RM, editors. Hogrefe Publishing Corp., 2019. Softcover, 396 pages. ISBN-13 978-0-88937-550-5. $137.95 ($117.26 for CSHP members).

The Clinical Handbook of Psychotropic Drugs for Children and Adolescents is well established as one of the essential references for medical professionals practising in the field of pediatric mental health. It is a comprehensive resource that combines evidence from scientific research with knowledge from leading clinical experts, presenting the material clearly and in a highly accessible format. Extensive information about topics such as the frequency of adverse effects and dosing considerations is conveniently condensed into well-organized tables. This feature, along with the use of colour coding, icons, and bullet-point format, makes navigation quick and easy.

As in the third edition, the latest handbook begins with brief overviews of the various psychiatric disorders that occur in children and adolescents, including up-to-date summaries on the following subjects: epidemiology, risk factors, comorbidities, presentation and symptoms, diagnosis, associated outcomes, and treatment. Then, clinically relevant information is presented separately for each class of psychotropic medication. Along with standard content such as indications and interactions, the insight provided in the “nursing implications” and “general comments” sections can be particularly useful in improving care plans and the patient experience.

It is worthwhile to highlight the chapter on antipsychotic-induced extrapyramidal side effects and their management. This chapter will be valuable in distinguishing among the many types of symptoms and syndromes and in considering the most appropriate therapeutic adjustments. Also, the charts listing the pharmacological effects of antidepressants and antipsychotics on various neurotransmitters and receptors are innovative and can be helpful in understanding a patient’s response to a particular agent. Another advantage of this reference is the detailed information on augmentation strategies provided at the end of each drug class section.

Several significant updates appear in this latest incarnation of the handbook. The recommendations on switching antidepressants have been fully revised, and now include more specific wash-out durations for each class of these medications. Switching methods (direct switches, stops, and cross-tapering) are further detailed, and there is increased emphasis on gradual, individualized tapering plans. The pharmacology section for second-generation antipsychotics has been expanded to include the proposed theory involving rate of dopamine receptor dissociation. Other changes include a comparison chart of treatments for nicotine use disorder and an updated section on unapproved treatments for psychiatric disorders, which summarizes recent studies involving agents such as N-acetylcysteine for cannabis use disorder and irritability in autism. Also, key material related to lithium toxicity and monitoring parameters for anti-psychotics has been revised and nicely reorganized into charts.

The fourth edition includes many new agents that have come to market since the last revision, in 2014. Among those currently approved for use in Canada, one third-generation antipsychotic, brexpiprazole, and a serotonin modulator and stimulator, vortioxetine, are notable additions.

Some practitioners will find that they need to consult other resources, to complement the valuable information in this volume. For example, anyone who is looking for supplemental information related to pharmacology may find a reference such as Stahl’s Essential Psychopharmacology (4th edition, Cambridge University Press, © 2008 or online edition) beneficial. For switching strategies for antidepressants and antipsychotics, the free online resource may be helpful, as it allows users to create specific, detailed, and visually appealing handouts useful for counselling patients and communicating recommendations to prescribers.

The Clinical Handbook of Psychotropic Drugs for Children and Adolescents is an exceptionally useful resource with which all clinicians and trainees involved in pediatric psychiatry should be familiar. A complete list of the updates included in the fourth edition, as well as preview pages, can be found on the publisher’s website ( An electronic version of the resource is also available by subscription.

The Clinical Handbook of Psychotropic Drugs for Children and Adolescents and other products and publications are available to CSHP members at a reduced rate through CSHP’s website, Members will be asked to log in before being allowed to proceed to CSHP’s virtual bookstore.

Pharmacy, IWK Health Centre, Halifax, Nova Scotia

Andrew Veysey also holds a Graduate Certificate in Mental Health and Addictions from Dalhousie University. ( Return to Text )

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Competing interests: None declared. ( Return to Text )

Canadian Journal of Hospital Pharmacy, VOLUME 72, NUMBER 3, May-June 2019