Journal of Child and Adolescent PsychopharmacologyVol. 33, No. 2 EditorialFree AccessFrom the Editor-in-Chief's DeskHarold S. KoplewiczHarold S. KoplewiczHarold S. Koplewicz, MD, Editor-in-ChiefChild Mind Institute, New York, New York, USA.Search for more papers by this authorPublished Online:20 Mar 2023https://doi.org/10.1089/cap.2023.29235.editorialAboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail To Our Readers:One of my proudest contributions as Editor-in-Chief of this journal has been working with a dedicated team to increase the global representation of research on child and adolescent psychopathology and medication treatment. This issue of the journal bears out this commitment. While Childress et al report on the important open-label safety trial of a new formulation of methylphenidate (MPH) for the treatment of attention-deficit/hyperactivity disorder (ADHD), we also have a paper from a Taiwanese group (Yu et al) on their systematic review and meta-analysis of guanfacine for ADHD treatment. Elsewhere, Büber et al provide valuable insight into prescribing trends for atypical antipsychotics in Turkish inpatient settings.Childress et al describe their trial of serdexmethylphenidate/dexmethylphenidate (SDX/d-MPH; brand name Azstarys), a mixture of d-MPH (which provides an immediate therapeutic effect) and its prodrug SDX (which is gradually converted to active d-MPH later in the day). SDX/d-MPH is approved for the treatment of patients aged 6 years or older with ADHD. The year-long open-label trial is the second phase 3 trial. The authors report that SDX/d-MPH is effective and safe. “SDX/d-MPH treatment produced a noticeable improvement in ADHD-RS-5 and CGI-S scores within 1 month of starting treatment,” they write, “and continued effectiveness was seen during the 1-year treatment period.” Although 60% of subjects reported an adverse event in the treatment phase, these percentages are “equivalent or fewer than those reported with other [MPH] treatments.”The paper from Yu et al on guanfacine, a non-stimulant second-line treatment for ADHD, is a helpful counterpart. In general, the authors report that guanfacine is effective and safe. Looking at the results of 12 randomized controlled trials comparing guanfacine to placebo, the authors were able to identify a population of 2273 participants with available safety data. In this group, 1437 (63.2%) received guanfacine, and 836 (36.8%) received a placebo. “Overall,” the authors write, “1170 (81.4%) participants in the guanfacine group experienced at least one treatment-emergent adverse event (TEAE) compared with 556 (66.5%) in the placebo group.” Low between-study heterogeneity indicates that there are certain persistent side effects of guanfacine, including dry mouth, somnolence, and sedation.Lastly, the paper from Büber et al echoes what we have learned from investigations of antipsychotic prescribing and polypharmacy in US and European settings. Their retrospective chart review included all patients treated at the Pamukkale University Hospital child and adolescent psychiatry inpatient service between 2015 and 2019. “Antipsychotic polypharmacy increased from 16.2% at admission to 30.7% at discharge,” the authors write. “Self-harm, aggression/violence, and extended hospitalization were factors associated with increased antipsychotic use. Psychotic symptoms, psychotic disorder, and extended hospitalization were factors associated with an increase in antipsychotic polypharmacy.”I hope you find the articles in this issue helpful and informative.FiguresReferencesRelatedDetails Volume 33Issue 2Mar 2023 InformationCopyright 2023, Mary Ann Liebert, Inc., publishersTo cite this article:Harold S. Koplewicz.From the Editor-in-Chief's Desk.Journal of Child and Adolescent Psychopharmacology.Mar 2023.39-39.http://doi.org/10.1089/cap.2023.29235.editorialPublished in Volume: 33 Issue 2: March 20, 2023PDF download