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Psychopharmacological Treatments in Children with Fetal Alcohol Spectrum Disorders: A Review

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Abstract

Psychiatric symptoms in children with Fetal Alcohol Spectrum Disorders (FASD) present with high prevalence and morbidity, often across symptom domains, e.g. ADHD-like symptoms, emotional dysregulation and sleep problems. Polypharmacy is often used, but no empirically-based guidelines exist regarding optimal treatment for these children. Moreover, stimulant use in these children is controversial as their responsiveness may be different due to altered neural circuitry associated with prenatal alcohol exposure. The objective of this review is to give an overview of existing data on pharmacological treatments of neurobehavioral symptoms in FASD. Our literature review yielded limited and conflicting clinical data on the effectiveness of pharmacological treatments for psychiatric symptoms in children with FASD, with some symptom domains lacking data altogether. We emphasize the need for clinical trials to guide pharmacological treatments in this complex population.

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Funding

Dr. Coles is currently receiving a grant from the Department of Behavioral Health and Developmental Disabilities, State of Georgia, Contract # 44100-907-0000056259. Dr. Ritfeld is currently supported by NIH/NIAAA Diversity Supplement 3U01AA026108-04S1, American Academy of Child and Adolescent Psychiatry (AACAP) Pilot Research Award for Junior Faculty and Child and Adolescent Psychiatry Fellows, supported by AACAP, and by the Emory University Psychiatry Residency Research Track, funded by NIH grant R25MH101079. For the remaining authors none were declared.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Drive NE, Suite 200, Atlanta, GA, USA

    Gaby J. Ritfeld, Julie A. Kable, Jennifer E. Holton & Claire D. Coles

  2. Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA

    Julie A. Kable & Claire D. Coles

Authors
  1. Gaby J. Ritfeld
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  2. Julie A. Kable
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  3. Jennifer E. Holton
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  4. Claire D. Coles
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Correspondence to Gaby J. Ritfeld.

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Ritfeld, G.J., Kable, J.A., Holton, J.E. et al. Psychopharmacological Treatments in Children with Fetal Alcohol Spectrum Disorders: A Review. Child Psychiatry Hum Dev 53, 268–277 (2022). https://doi.org/10.1007/s10578-021-01124-7

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