I. General Principles.- 1.Introduction: A Guide for Practitioners, Professionals, and Public.- I. Introduction.- A. Preamble.- B. Definitions.- C. The Multidisciplinary Team.- D. Child Psychiatry and Behavioral Pediatrics.- II. Historical Overview.- A. Foundations.- B. Current Trends and Future Directions.- III. Classification of Psychoactive Drugs.- A. Names of Drugs.- B. Look-Alike Drugs.- IV. Drug Evaluation.- V. Determinants of Prescribing.- A. Medical Knowledge.- B. Patient and Parent Factors.- C. Physician Factors.- D. Social Factors.- E. Economic Factors.- F. The Powerful Placebo.- VI. Principles of Drug Use.- A. First Do No Harm (Prima Non Nocere).- B. Know the Disorder and Use Drugs When Indicated.- C. Choose the Best Drug.- D. Understand the Drug and Its Properties.- E. Minimize Drug Use and Dosage.- F. Keep Things Simple.- G. Avoid Polypharmacy.- H. Don't Be a Fiddler.- I. Don't Follow Fads.- J. Take Particular Care with Children.- K. Establish a Therapeutic Alliance.- VII. Conclusion.- References.- 2. Pharmacology.- I. Introduction.- II. Fate of Drugs in the Body.- A. Passage of Drugs across Biological Membranes.- B. Routes of Drug Administration.- C. Distribution.- D. Elimination.- 1 Excretion.- 2 Biotransformation.- 3 Variability in Human Drug Biotransformation.- III. Pharmacokinetics.- A. Apparent Volume of Distribution.- 1 One-Compartment Model.- 2 Two-Compartment Model.- B. Elimination and Clearance.- 1 Flow-Limited Clearance.- 2 Capacity-Limited Clearance.- 3 Dosage, Clearance, and Half-Life.- C. Multiple Dosing and Steady-State Drug Concentrations.- D. Saturation Kinetics.- IV. Time Course of Pharmacological Effect.- A. Nonlinear Concentration-Response Curve.- B. Slow Equilibration with Site of Drug Action.- C. Presence of Active Metabolites.- D. Indirect or Slow Biochemical Response.- V. Pediatric Variations in Pharmacokinetics.- A. Absorption.- B. Distribution.- C. Biotransformation and Excretion.- D. Response.- VI. Mechanisms of Drug Action (Pharmacodynamics).- A. Enzymes.- B. Voltage-Gated Ion Channels.- C. Reuptake Mechanisms.- D. Receptors.- 1 Dose-Response Curve.- 2 Receptor Number and Distribution.- 3 Receptor Subtypes.- 4 Modeling of Drug-Receptor Interactions.- E. Mechanisms of Receptor Action.- 1 Ligand-Gated Ion Channels.- 2 G-Protein-Linked Receptors.- 3 Second and Third Messengers.- F. Speed of Response of Receptors.- G. Summary of Mechanisms of Receptor Activation.- References.- 3. Prevalence of Drug Therapy.- I. Introduction.- A. Research Objectives.- B. Scope of the Review.- II. Hyperactivity (Attention-Deficit Hyperactivity Disorder).- A. Early Studies.- B. Recent Surveys.- C. Special Education.- D. Socioeconomic Status.- E. Treatment Practices.- F. National Estimates of Treatment Prevalence.- III. Mental Retardation.- A. Institutional Settings.- B. Community-Based Facilities.- C. Public Schools.- D. National Estimates of Treatment Prevalence.- IV. Seizure Disorders.- A. Autism.- B. Mental Retardation.- C. Preschool-Aged Children.- V. Autism.- VI. Depression.- VII. Enuresis.- VIII. Tourette Syndrome.- IX. Other Disorders.- X. Summary.- References.- 4. Monitoring and Measuring Drug Effects. I. Physical Effects.- I. Introduction.- II. Baseline Physical Assessment.- A. Past Medical History.- B. Immunizations.- C. Hospitalizations.- D. Trauma.- E. Transfusions.- F. Current Medications.- G. Allergies.- H. Substance Use History.- I. Social History.- J. Family Medical History.- K. Family Psychiatric History.- III. Medical Review of Organ Systems.- A. General Health.- B. Eyes, Ears, Nose, and Throat.- C. Respiratory.- D. Cardiovascular.- E. Gastrointestinal.- E. Urinary Tract.- G. Genital and Reproductive Systems.- H. Musculoskeletal System.- I. Integument (Skin).- J. Endocrine System.- K. Central Nervous System.- IV. Psychiatric Review.- V. Physical and Neurological Exam.- VI. Baseline Biochemical Assessment of Blood and Urine.- VII. Speech and Language Assessment.- VIII. Monitoring Side Effects.- A. General Principles.- B. Types of Measures.- C. Formal Side Effect Rating Scales.- 1. Side Effects Rating Scales.- 2. Physical and Neurological Exam for Soft Signs.- D. Compliance with Medication.- IX. Laboratory Measures and Monitoring.- A. Electrocardiogram.- B. Dexamethasone Suppression Test.- C. Thyroid Function Tests.- D. Electroencephalography.- E. Catecholamine and Enzyme Assays.- F. Lumbar Punctures.- G. AIDS Screening.- H. Toxicology.- I. Genetic Studies.- J. Brain Imaging.- K. Routine Liver, Kidney, and Serum Measures.- X. Conclusions.- References.- 5. Monitoring and Measuring Drug Effects. II. Behavioral, Emotional, and Cognitive Effects.- I. Introduction.- II. Measurement.- A. Diagnosis.- 1 Unstructured.- 2 Structured.- 3 Semistructured.- 4 Symptom Checklists.- 5 Adolescents.- 6 Summary.- III. Rating Scales.- A. Some General Considerations.- B. General-Purpose Rating Scales.- 1 Clinical Global Impressions (CGI).- 2 Customized Scales.- 3 Child Behavior Checklist and Its Analogues.- 4 Revised Behavior Problem Checklist (RBPC).- C. Hyperactivity (ADHD).- 1 Teacher Rating Scales.- a. ADHD-Only Instruments.- b. Scales for ADHD plus Other Symptoms.- 2 Parent Rating Scales.- a. ADHD-Only Instruments.- b. Scales for ADHD plus Other Symptoms.- 3 Self-Rating Hyperactivity Scales.- 4 Situation-Specific Scales.- 5 Summary.- D. Oppositional, Conduct, and Aggressive Problems.- 1 Introduction.- 2 Informant Instruments.- a. The Conners Scales.- b. The Peer Conflict Scale.- c. Child Behavior Checklist and Teacher Report Form.- d. The Revised Behavior Problem Checklist.- e. Inpatient Rating Scales.- 3 Self-Rating Scales.- a. The Youth Self Report.- b. Children's Inventory of Anger.- 4 Conclusions.- E. Depression.- 1 Self-Rating Scales.- a. Children's Depression Inventory (CDI).- b. Children's Depression Scale (CDS).- c. Depressive Self-Rating Scale.- d. The Reynolds Scales.- e. Conclusion.- 2 Informant (Parent and Teacher) Scales.- a. Children's Depression Inventory.- b. Children's Depression Scale.- c. Bellevue Index of Depression (BID).- d. Emotional Disorders Rating Scale (EDRS).- e. Rating Scale of Dysphoria (RSD).- f. Conclusion.- 3 Interviews.- a. Children's Depression Rating Scale - Revised.- b. Bellevue Index of Depression.- c. Other Interview Schedules.- 4 Other Instruments.- 5 Conclusions.- F. Bipolar (Manic-Depressive) Mood Disorder (Mania).- G. Anxiety Disorders.- 1 Self-Rating Scales.- a. Fear Survey Schedule for Children (FSSC-R).- b. Revised Children's Manifest Anxiety Scale (RCMAS).- c. Childhood Anxiety Sensitivity Index (CASI) and Child Anxiety Frequency Checklist (CAFC).- d. State-Trait Anxiety Scale for Children.- 2 Specific Anxiety Disorders.- a. Obsessive-Compulsive Disorder (OCD).- b. Panic Disorder.- c. Separation Anxiety Disorder.- d. Phobic Disorders.- e. Posttraumatic Stress Disorder.- 3 Personality Scales.- 4 Behavior Rating Scales for Anxiety.- a. Louisville Behavior Check List.- b. Louisville Fear Survey for Children.- 5 Structured Interviews.- 6 Conclusions.- H. Other Disorders.- 1 Schizophrenia.- 2 Tic and Tourette Disorders.- I. Mental Retardation.- 1 The Aberrant Behavior Checklist (ABC).- 2 Behavior Problems Inventory (BPI).- 3 Emotional Disorders Rating Scale for Developmental Disabilities.- 4 Maladaptive Behavior Scale.- 5 Other Instruments.- J. Autism.- 1 The Children's Psychiatric Rating Scale (CPRS).- 2 Aberrant Behavior Checklist.- 3 Conners Abbreviated Symptom Questionnaire.- 4 Timed Stereotypies Rating Scale.- 5 Ritvo-Freeman Real Life Rating Scale for Autism.- 6 Conclusion.- K. Preschool Rating Scales.- 1 Introduction.- 2 Child Behavior Checklist.- 3 The Preschool Behavior Questionnaire (PBQ).- 4 Other Preschool Instruments.- a. The Behavioural Screening Questionnaire (BSQ).- b. The Symptom Checklist.- c. Temperament Scales.- 5 Conclusion.- IV. Direct Observation.- A. General Considerations.- B. Types of Direct Observation Methods.- C. Some Illustrative Examples.- 1 Hyperactivity (ADHD).- 2 Conduct Disorder and Aggression Problems.- 3 Depression.- 4 Anxiety Disorders.- 5 Conclusion.- V. Performance, IQ, Achievement, and Automated Activity Measures.- A. Performance and Related Tests.- 1 Continuous Performance Task (CPT).- 2 Cancellation Tasks.- 3 Matching Familiar Figures (MFF) Task.- 4 Analogue Classroom Tests.- 5 Paired Associate Learning (PAL).- 6 Delay Task.- 7 Short Term Recognition Memory Task.- 8 Automated Measures of Activity Level.- B. Computer Testing.- 1 Advantages and Disadvantages.- 2 Current Status and Examples.- a. Gordon Diagnostic System.- b. Serial Recall: Assessment.- c. Test of Variables of Attention (TOVA).- d. The Fe Psy (Iron Psych) Test System.- C. IQ and Achievement Tests.- 1 IQ Tests.- 2 Achievement Tests.- a. General Considerations.- b. Some Specific Tests.- VI. Conclusions.- References.- 6. Medicolegal and Ethical Issues in the Pharmacologic Treatment of Children.- I. Introduction.- II. Obtaining Consent for Treatment.- A. The Doctrine of Informed Consent.- B. Elements of Informed Consent.- 1 Information.- 2 Voluntariness.- 3 Competency.- C. Exceptions to the Requirements of Informed Consent.- D. Special Consent Issues with Children and Adolescents.- 1 Parental Authority.- 2 The Authority of Children.- 3 Developmental Aspects of Competency.- 4 Assent.- E. Consent Procedures in Practice.- F. Documenting Informed Consent.- III. The Right to Refuse Treatment.- IV. Consent to Treatment and the Custody Problem.- V. Confidentiality.- VI. Risk Management in the Treatment of Children and Adolescents.- VII. Conclusions.- References.- 7. Disorders, Symptoms, and Their Pharmacotherapy.- I. Introduction.- II. Disruptive Behavior Disorders.- A. Attention-Deficit Hyperactivity Disorder.- 1 Diagnostic Features and Pharmacotherapy.- a. Stimulants.- b. Tricyclic Antidepressants.- c. Neuroleptics (Antipsychotics).- d. Other Drugs.- 2 Potential Biochemical Correlates.- B. Conduct Disorders.- 1 Diagnostic Features and Pharmacotherapy.- 2 Potential Biochemical Correlates.- C. Oppositional Defiant Disorder.- III. Mood Disorders.- A. Major Depressive Disorder (MDD).- 1 Diagnostic Features and Pharmacotherapy.- 2 Potential Biochemical Correlates.- B. Bipolar Disorder.- 1 Diagnostic Features and Pharmacotherapy.- 2 Potential Biochemical Correlates.- I. Schizophrenic Disorders.- A. Diagnostic Features and Pharmacotherapy.- B. Potential Biochemical Correlates.- V. Developmental Disorders.- A. Mental Retardation.- 1 Diagnostic Features and Pharmacotherapy.- 2 Potential Biochemical Correlates.- B. Specific Developmental Disorders.- C. Pervasive Developmental Disorder.- 1 Diagnostic Features and Pharmacotherapy.- 2 Potential Biochemical Correlates.- VI. Eating Disorders.- A. Anorexia Nervosa.- B. Bulimia Nervosa.- 1 Diagnostic Features and Pharmacotherapy.- 2 Potential Biochemical Correlates.- C. Pica.- D. Rumination Disorder of Infancy.- VII. Gender Identity Disorder.- VIII. Anxiety Disorders.- A. Overanxious Disorder.- B. Separation Anxiety Disorder.- C. School Phobia.- D. Avoidant Disorder.- E. Posttraumatic Stress Disorder (PTSD).- F. Obsessive-Compulsive Disorder (OCD).- 1 Diagnostic Features and Pharmacotherapy.- 2 Potential Biochemical Correlates.- IX. Tic Disorders.- A. Simple Tics.- B. Tourette Syndrome.- 1 Diagnostic Features and Pharmacotherapy.- 2 Potential Biochemical Correlates.- X. Psychoactive Substance Abuse and Dependence Disorders.- XI. Sleep Disorders.- XII. Elimination Disorders.- A. Enuresis.- 1 Diagnostic Features and Pharmacotherapy.- 2 Potential Biochemical Correlates.- B. Encopresis.- XIII. Dimensional Considerations.- A. Aggression.- 1 Clinical Features and Pharmacotherapy.- 2 Potential Biochemical Correlates.- B. Attention.- XI. Summary.- References.- II. Specific Drugs.- 8. Stimulants.- I. Pharmacological Aspects of Stimulant Medication: Definition and Nomenclature.- A. Pharmacology.- B. Pharmacokinetics.- II. Clinical Effects: Short-Term.- A. General Clinical Effects.- B. Physical Effects.- C. Effects on Behavior and Emotion.- D. Effects on Cognition, Learning, and Academic Performance.- E. Effects on Social Systems.- F. Dose Effects on Behavior and Learning.- III. Clinical Effects: Long-Term.- IV. Predicting the Clinical Response to Stimulants.- V. Side Effects and Toxicity.- A. Lethal Dose.- B. Short-Term Side Effects.- 1 Usual Side Effects.- 2 Tics.- 3 Behavioral Rebound.- 4 Cognitive Toxicity.- 5 Behavioral Toxicity.- 6 Idiosyncratic Side Effects.- 7 Summary of Short-Term Side Effects.- C. Long-Term Side Effects.- 1 Drug Dependence and Abuse.- 2 Height and Weight Suppression.- 3 Cardiovascular Effects.- VI. Clinical Indications and Usage.- A. Standard Indications.- B. Probable Indications.- C. Usage.- 1 When to Use Medication.- 2 Initial Medical Workup.- 3 Prescribing and Titrating.- D. Monitoring Response to Medication.- 1 Assessing Initial Response to Medication.- 2 Maintenance on Medication.- a. Assessing Progress.- b. When the Effect Appears to Diminish.- c. Side Effects.- d. Reassessment.- E. Discontinuing Medication.- VII. Contraindications and Drug Interactions.- VIII. Summary.- IX. Conclusion.- References.- 9. Antidysthymic Drugs (Antidepressants and Antimanics).- I. Introduction.- II. Diagnosis and Epidemiology of Depression in Children and Adolescents.- III. Antidepressants.- A. Types.- B. Heterocyclic Antidepressants.- 1 Definition, Classes, Generic and Trade Names.- 2 Cellular Actions.- 3 Pharmacokinetics.- 4 Behavioral and Emotional Effects.- 5 Cognitive and Learning Effects.- 6 Physiological Side Effects.- 7 Adverse Effects.- 8 Clinical Indications.- a. Mood Disorders.- b. Attention-Deficit Hyperactivity Disorder (ADHD).- c. Enuresis.- d. Anxiety Disorders.- 9 Contraindications and Drug Interactions.- C. Monoamine Oxidase Inhibitors.- 1 Definitions and Classes.- 2 Pharmacology.- 3 Clinical Effects.- 4 Clinical Indications.- a. Affective Disorders.- b. Attention-Deficit Disorders.- 5 Side Effects and Drug Interactions.- 6 Contraindications.- D. Summary of Antidepressant Treatment of Children and Adolescents.- IV. Antimanics.- A. Introduction.- 1 Epidemiology of Mania.- 2 Antimanic Drugs.- B. Lithium.- 1 Definition.- 2 Cellular Actions.- 3 Pharmacokinetics.- 4 Behavioral and Emotional Effects.- 5 Cognitive and Learning Effects.- 6 Adverse Effects.- 7 Clinical Indications and Usage.- a. General Diagnostic Considerations.- b. Medical Workup.- c. Treatment in Bipolar Disorders.- d. Effects on Aggressive Behavior.- e. Attention-Deficit Hyperactivity Disorder.- f. Unipolar Major Depression.- g. Dosage.- h. Contraindications and Drug Interactions.- C. Carbamazepine.- 1 Pharmacology.- 2 Clinical Effects.- a. Behavioral Effects.- b. Pharmacokinetics, Dosage, and Blood Levels.- 3 Clinical Indications.- 4 Side Effects.- D Valproate.- 1 Pharmacology.- 2 Clinical Effects.- 3 Clinical Indications.- 4 Side Effects.- E. Clonazepam.- 1 Pharmacology.- 2 Clinical Effects.- 3 Clinical Indications.- 4 Side Effects.- F. Summary of Antimanics in Child and Adolescent Disorders 262 References.- 10. Antipsychotics (Neuroleptics).- I. Definition, Classes, Individual Drugs, Generic and Trade Names.- II. Pharmacology and Pharmacokinetics.- A. Cellular Effects.- B. Pharmacokinetics.- 1 Oral Administration.- 2 Parenteral Administration.- 3 Depot Preparations.- 4 Therapeutic Effect.- 5 Blood Levels.- 6 Pharmacokinetics in Children.- C. System Effects.- D. Interactions.- III. Clinical Indications and Usage.- A. Indications.- 1 Dosage.- 2 Pretreatment Screening.- B. Schizophrenia.- C. Psychotic Depression and Bipolar Disorder.- 1 Psychotic Depression.- 2 Bipolar Disorder (i.e., Manic or Manic and Depressive Episodes).- D. Conduct Disorder and Conduct Problems.- E. Autism and Other Pervasive Developmental Disorders (PDD).- F. Tourette Syndrome.- G. Mental Retardation Associated with Disruptive Behavior or Psychiatric Disorder.- 1 Short-Term Efficacy.- 2 Effects on Cognition.- H. Attention-Deficit Hyperactivity Disorder (ADHD).- 1 Short-Term Efficacy.- a. Phenothiazines.- b. Butyrophenones.- 2 Effects on Cognition.- IV. Untoward Side Effects.- A. Immediate/Early Untoward Effects.- 1 Behavioral Toxicity.- 2 Extrapyramidal Side Effects.- 3 Sedation.- 4 Endocrine Effects.- 5 Cardiovascular Effects.- 6 Skin Reactions and Photosensitivity.- 7 Hepatic Dysfunctions.- 8 Ocular Reactions.- 9 Tissue Necrosis and Vasculitis.- 10 Blood Dyscrasias.- 11 Seizures.- 12 Neuroleptic Malignant Syndrome.- B. Long-Term Untoward Effects.- 1 Abnormal Involuntary Movements.- 2 Growth.- 3 Withdrawal Symptoms.- 4 Management of Late Effects.- V. Summary/Conclusions.- References.- 11. Drugs of Abuse.- I. Introduction.- II. Definitions.- III. Epidemiology.- A. Frequency and Type of Substance Abuse.- B. Risk Factors for Abuse.- I. Etiology.- A. Predisposing Personality Traits.- B. Biochemical Markers.- V. Patterns of Abuse and Outcome.- VI. Principles of Diagnosis.- A. Accurate History.- B. Comorbid Psychiatric Conditions.- C. Health Problems.- D. Laboratory Evaluation.- E. Social Assessment.- VII. Substances of Abuse.- A. CNS Depressants.- 1 Alcohol.- a. Pharmacology.- b. Patterns of Abuse.- c. Effects.- d. Tolerance and Dependence.- e. Treatment.- 2. Sedati.- v. Hypnotics.- a. Pharmacology.- b. Patterns of Nontherapeutic Use.- c. Effects.- d. Tolerance and Dependence.- e. Toxicity and Management.- f. Clinical Indications.- 3. Inhalants.- a. Pharmacology.- b. Patterns of Use.- c. Effects.- d. Tolerance and Dependence.- e. Treatment.- B. Psychostimulants.- 1 Pharmacology.- 2 Patterns of Use.- 3 Effects.- 4 Tolerance and Dependence.- 5 Treatment.- 6 Therapeutic Indications.- C. Nicotine.- 1 Pharmacology.- 2 Patterns of Use.- 3 Effects.- 4 Tolerance and Dependence.- 5 Treatment.- 6 Therapeutic Uses.- D. Dissociative Agents.- 1 Pharmacology.- 2 Patterns of Use.- 3 Effects.- 4 Tolerance and Dependence.- 5 Treatment.- E. Hallucinogens.- 1 Cannabino.- a. Pharmacology.- b. Patterns of Use.- c. Effects.- d. Tolerance and Dependence.- e. Treatment.- f. Therapeutic Indications.- 2 Other Hallucinogens.- a. Pharmacology.- b. Patterns of Use.- c. Effects.- d. Tolerance and Dependence.- e. Treatment.- f. Therapeutic Indications.- F. Opiates.- 1 Psychopharmacology.- 2 Patterns of Use.- 3 Effects.- 4 Tolerance and Dependence.- 5 Treatment.- G. Miscellaneous Agents.- VIII. Principles of Treatment.- A. Treatment Programs.- 1 Outpatient Programs.- 2 Inpatient Programs.- 3 Aftercare.- 4 Residential Treatment.- B. Pharmacotherapy.- C. Treatment Outcome.- IX. Conclusions.- References.- 12. Antiepileptics (Anticonvulsants).- I. Introduction.- II. The Use of Drugs in Epilepsy.- A. When to Prescribe.- 1 Risk of Recurrence of Seizures.- 2 Conseqences of Recurrence of Seizures.- 3 Cost/Benefit of AEDs.- B. Rationale for Prescription.- 1 Type of Seizure.- 2 Other Factors in Drug Choice.- C. The Treatment Plan.- III. Pharmacology of Drugs Used in Epilepsy.- A. AEDs in General.- B. Bromides.- C. Barbiturates.- 1 Phenobarbital.- 2 Mephobarbital (Mebaral (R)).- 3 Primidone (Mysoline (R)).- D. Hydantoins (Phenytoin, Mephenytoin, Ethotoin).- 1 Phenytoin (Dilantin (R)).- 2 Other Hydantoins.- E. Succinimides.- 1 Ethosuximide (Zarontin (R)).- 2 Methsuximide (Celontin (R)).- 3 Phensuximide (Milontin (R)).- F. Carbamazepine (Tegretol (R)).- G. Valproic Acid (Depakene (R), Depakote (R), Epilim (R)).- H. Benzodiazepines (Diazepam, Clonazepam, Lorazepam, Clorazepate).- I. New Drugs.- IV. Cognitive and Behavioral Function and Epilepsy.- A. The Role of Epilepsy.- B. The Role of Psychosocial Factors.- C. The Role of AEDs.- V Cognitive/Behavioral Effects of AEDS in Children.- A. Phenobarbital.- B. Phenytoin.- C. Carbamazepine.- D. Valproate.- E. Benzodiazepines.- VI. Psychoactive Effects of AEDs.- A. Carbamazepine.- B. Valproate.- C. Other AEDs.- VII. Summary.- References.- 13. Psychoactive Effects of Medical Drugs.- I. Introduction.- A. Use of Medical Drugs by Children.- B. Prevalence of Psychoactive Effects of Medical Drugs in Children.- C. Management of Psychoactive Effects.- D. Attribution of Psychoactive Effects.- E. A Proposed Classification of Psychoactive Effects of Medical Drugs.- II. Types of Psychoactive Effects.- A. Intoxication.- 1 Diagnosis and General Features.- 2 Drugs Causing Intoxication.- 3 Management of Intoxication.- B. Delirium.- 1 Diagnosis and General Features.- 2 Drugs Causing Delirium.- 3 Management of Delirium.- C. Organic Delusional Syndrome.- 1 Diagnosis and General Features.- 2 Drugs Causing Organic Delusional Syndrome.- 3 Management of Organic Delusional Syndrome.- D. Organic Hallucinosis.- 1 Diagnosis and General Features.- 2 Drugs Causing Organic Hallucinosis.- 3 Management of Organic Hallucinosis.- E. Organic Mood Syndrome.- 1 Manic Reaction.- a. Diagnosis and General Features.- b. Drugs Causing Manic Reaction.- c. Management of Manic Reaction.- 2 Depressive Reaction.- a. Diagnosis and General Features.- b. Drugs Causing Depressive Reaction.- c. Management of Depressive Reaction.- F. Organic Anxiety Syndrome.- 1 Diagnosis and General Features.- 2 Drugs Causing Organic Anxiety Syndrome.- 3 Management of Anxiety Reactions.- III. Implications for Clinical Practice and Further Research.- IV. Conclusions.- References.- 14. Nootropics and Foods.- I. Introduction.- II. Nootropics.- A. Definition.- B. Mechanism of Action.- C. Human Studies.- D. Conclusions.- III. Food.- A. Constituent Effects.- 1 Sweeteners.- a. Sugar.- b. Aspartame.- 2 Caffeine.- 3 Chocolate.- 4 Precursors of Biochemical Substances.- a. Tryptophan.- b. Choline and Tyrosine.- 5 Vitamins.- a. Deficiency States.- b. Supplementation in Normal Amounts.- c. Megavitamins.- 6 Trace Minerals.- 7 Heavy Metals.- 8 Food Additives.- IV. Some Clinical Guidelines for Working with Parents.- A. Food Histories as Part of Regular History-Taking.- B. Ally with Parental Biases, Not against Them.- C. Monitor Food Behavior during Treatment.- V Conclusions.- References.- 15. Anxiolytics, Sedatives, and Miscellaneous Drugs.- I. Introduction.- II. Anxiolytics and Sedatives.- A. Anxiolytics and Sedatives Defined.- B. CNS Depressants.- 1 Pharmacology.- a. Classification and Action.- b. Use.- c. Types, Potencies, and Pharmacokinetics.- 2 Effects.- a. CNS.- b. Other Body Systems.- 3 Clinical Indications.- a. Anxiety Disorders.- b. Sleep Disorders.- c. Excited/Aggressive States.- 4 Adverse Effects.- 5 Prescribing Guidelines.- a. Deciding to Prescribe.- b. Route.- c. Choice of Benzodiazepine.- d. Dosage and Duration.- C. Antihistamines and Anticholinergics.- D. Atypical Anxiolytics.- E. Summary of Anxiolytics and Sedatives.- III. Miscellaneous Drugs.- A. Clonidine.- 1 Pharmacology.- 2 Clinical Indications.- 3 Clinical Usage.- 4 Summary.- B. L-Tryptophan and 5-Hydroxytryptophan.- C. Fenfluramine.- 1 Pharmacology.- 2 Clinical Indications.- a. Autism.- b. ADHD.- c. Mental Retardation.- 3 Clinical Usage.- a. Dosage.- b. Side Effects and Toxicity.- 4 Summary.- D. ?-Adrenergic Blockers (?-Blockers).- 1 Pharmacology.- 2 Clinical Indications.- a. Aggression.- b. Anxiety.- 3 Clinical Usage.- a. Dosage.- b. Side Effects.- c. Contraindications.- d. Interactions.- 4 Summary.- E. Opiate Blockers.- 1 Pharmacology.- 2 Clinical Indications.- a. Self-Injury.- b. Autism.- 3 Clinical Usage.- a. Dosage.- b. Side Effects.- c. Contraindications.- 4 Summary.- IV. Summary.- References.- Appendix A Major Psychoactive Medications Grouped by Drug Class.- Appendix B Major Psychoactive Medications Ordered by Trade Name.