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There is a g r o w i n g b o d y o f evidence that these three medications m a y hold substantial promise for the treatment o f younger patients with s c h i z o phrenia. S o m e c a s e series i n v o l v i n g each o f the agents h a v e s h o w n substantial diminishment o f s y m p t o m s with g o o d rates o f acceptability. T h e s e n e w m e d i c i n e s are helpful; h o w e v e r , they should b e u s e d w i t h care b e c a u s e they all h a v e the potential for adverse events, including tardive dyskinesia.

The most c o m m o n l y accepted c o n c e p tualization for the etiology o f M D D in children and adolescents is a b i o psychosocial model. This hypothesis asserts that M D D m a y b e precipitated by a combination o f genetic, biological, psychological, and environmental factors. Evidence that genetic factors m a y have a role in the development o f M D D has c o m e from a variety o f different types o f studies. One avenue o f research has investigated the prevalence o f M D D in the offspring o f depressed individuals.

Schizophrenia 27 Currently, however, there is not a single medication that is the best choice for pharmacological treatment o f schizophrenia in children and adolescents. B a s e d on the available literature, w e generally recommend treatment be initiated with one o f the front line atypical antipsychotics. B e c a u s e it appears that rapid increases in antipsychotic dosing m a y increase the risk o f side effects, a rational approach to treating y o u n g patients with these agents is to start at a l o w dose and gradually increase the dose as needed.

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Alvin and the Chipmunks - Merry Christmasm Mr. Carroll!


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