Answer to Question 1
The benefits are modest at best in preventing further deterioration of the disease. The percentage of patients obtaining a clinically relevant benefit from treatment with these drugs ranges from 25 to 54 versus 7 to 27 with placebo for cognitive improvement and ranges from 25 to 32 versus 11 to 19 with placebo for improvement in global measures of functioning.
Answer to Question 2
First, specific diagnoses are more difficult in children because children lack the verbal abilities to describe what may be troubling to them, and normal children act in bizarre ways at times, and develop through various stages rapidly. Also, there may not be a stable history to look back on, as one might do with an adult. Although children may present with the same disorders as adults, e.g., anxiety and affective disorders, but the symptoms may be different. Second, there are few clinical trials conducted with children with the psychotropics that are used in the treatment of adults. Dosages appropriate for adults may not be appropriate for children, often because children metabolize drugs more efficiently than adults. Thirdly, information on treatment efficacy comes less from the child being treated and more from the observers of the child, who may differ on the outcome of a drug treatment.
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