Newer Modalities in Psychopharmacology in Children and Adolescents: A Selective Narrative Review of the Literature

Introduction: Research in psychopharmacology in children and adolescents is an area of growing interest with several newer modalities becoming available in recent years. Nevertheless, it still lags significantly behind research in adult psychopharmacology although, in the last decade, the gap is beginning to be bridged with FDA approval for newer agents for the pediatric age group. The purpose of this selective narrative review is to examine the latest advances in psychopharmacology in the last decade and their safety, tolerability, and applicability in children and adolescents. Methods: We selected 4 main areas of recent advances in psychopharmacology, namely ketamine, nitrous oxide, cannabidiol, and cannabis derivates and the area of pharmacogenomics. We then conducted a comprehensive search of the literature using PubMed, Embase, and Ovid databases to identify the most recent updates in these areas, especially focused on the pediatric population. The search was limited to English language studies and focused on recent updates in these 4 areas. Results: All the 4 identified areas have potential applicability in children and adolescents with some studies evaluating their safety and tolerability in the pediatric population. However, literature on the long-term safety and efficacy of these newer modalities in the pediatric population is limited and none of the identified agents are currently recommended for routine clinical use in children and adolescents. Conclusions: Overall, the results of this selective narrative review suggest that newer modalities in psychopharmacology offer promising treatments for psychiatric disorders in children and adolescents. However, further research is needed to fully understand the long-term safety and efficacy of these treatments as well as optimal dosing and monitoring strategies to ensure their safe and effective use in the pediatric population.