[Prescription of neuroleptics for children].

The discovery of neuroleptics has certainly not had the same impact in child psychiatry as it has had in adult psychiatry. Yet, these substances are widely used with children. Prescription is generally based on a few simple rules: treatment is started with low doses which are progressively increased, so as to reach an optimal posology which establishes a balance between clinical efficiency and side effects; plasmatic levels may be monitored on a regular basis. The emergence of adverse effects continues to remain the essential preoccupation of the clinical practitioner; it is the reason why so many treatment plans are discontinued (on a short term basis, acute dyskinesia, sedation, hypotension, weight gain; on a long-term basis, passiveness, tardive dyskinesia, but this is seldom observed in children). As a result, one must be careful in prescribing neuroleptics to youngsters and consider other drugs whenever possible. Following a brief review of the kinetic specificities of neuroleptics in children, we describe the general modalities of prescription for this age group and give some personal results as illustrative examples. We then discuss the issue of tolerance and side effects.