The Psychopharmacology Core is designed to be a unit that is tightly integrated into the general intervention research program as one element of the approach to treating childhood onset psychiatric disorders. The central goals of the Core will be to facilitate the conduct of state-of-the-art studies of the safety, efficacy and effectiveness of pharmacological interventions in children and adolescents with psychiatric disorders and to facilitate the examination of the mechanisms of action of such interventions. The necessity of a Core such as this is evident from the fact that there is marked discrepancy between the data on pediatric medication usage and the studies of efficacy. There are simply insufficient data on safety and efficacy. This is because there are remarkably few methodologically-sound, randomized controlled trials of medications in the treatment of childhood onset psychopathology. This is complicated further by the lack of adequate studies that investigate the basic mechanisms of response to medications in children and adolescents, including pharmacokinetic, pharmacodynamic, neurotransmitter and pharmacogenetic studies. The absence of these sorts of strategies in child and adolescent psychopharmacology also means that there is a shortage of medications designed specifically to address childhood onset disorders. These are pressing problems that are significantly limiting progress in child and adolescent psychopharmacology. In advance of this application, the program at Columbia has had active investigations in the area of pediatric psychopharmacology. These have been funded from a variety of sources including NIH, pharmaceutical companies and foundation monies. There are extensive previous and ongoing studies on the use of pharmacologic agents to treat depression, anxiety disorders, ADHD and eating disorders. There have also been extensive studies of the mechanism and prediction of medication response or adverse effects. Some of these studies have been quite basic, but nonetheless important, while others have been innovative and creative.
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