Atypical antipsychotics for the treatment of disruptive behavior.

Pediatric primary care providers increasingly are expected to evaluate and manage child mental health conditions.1 To do so effectively, it is important for pediatric providers to develop their knowledge and skills in this area.2 Aggression is one of the most common problems facing child clinicians, and many interventions have been shown to be effective for these problems. While psychosocial interventions should be used to treat aggression initially, medications often play an important role. Atypical antipsychotics, also known as second-generation antipsychotics, (SGAs), are the most commonly prescribed medication for acute/chronic aggression.3 From 1993 to 2002 the number of office-based visits by youth that included antipsychotic medication rose from 200,000 to more than 1.2 million for diagnoses of disruptive behavior disorders (37.8%), mood disorders (31.8%), pervasive developmental disorders or mental retardation (17.3%), or psychotic disorders (14.2%).4 In a recent study of trends in prescriptions of antipsychotics within the Texas Medicaid Program, the prevalence of atypical antipsychotic use Atypical Antipsychotics for the Treatment of Disruptive Behavior