Long-term drug use in psychiatric disorders in children. Facts, controversies and the future.

This paper is part of a special section on 'psychopharmacotherapy in children' and deals with facts, controversies and the future of the long-term use of pharmacotherapy in child and adolescent psychiatric disorders. This topic has been little studied because of career disincentives and practical difficulties. Indications for long-term use require evidence of short-term efficacy and safety, a chronic or recurring disorder and continuing proof of effect. Early onset of disorders usually found in adults, such as schizophrenia and bipolar mood disorder, form the clearest indications; but among the child disorders, attention deficit disorder has the most supporting evidence, though medication appears to have little effect on long-term outcome. There is need for further research.