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Although the use of psychotropic medications in child and adolescent psychiatry in Germany is on the increase, most compounds are in fact prescribed "off-label" because of a lack of regulatory approval in these age groups. In 2007, the European Parliament introduced Regulation 1901/2006 concerning medicinal products in pediatric populations, with a subsequent amendment in the form of Regulation 1902/2006. The main aim of this legislation was to encourage research and clinical trials in children and adolescents, and thus promote the availability of medications with marketing authorization for these age groups. Furthermore, initiatives such as the European 7th Framework Program of the European Union now offer substantial funding for pediatric pharmacological research. At a recent Congress of the German Society for Child and Adolescent Psychiatry and Psychotherapy (DGKJP), experts from the field and the pharmaceutical industry held a symposium with lay representatives in order to discuss attitudes toward, and experience with, pediatric psychopharmacology research in Germany since 2007. Several areas of concern were identified. The present paper derives from that symposium and provides an overview of these opinions, which remain crucial to the field. A wider discussion of how to facilitate psychopharmacological research in Germany in order to optimize the treatment and welfare of children and adolescents with psychiatric disorders is now warranted.

All registered general practitioners, pediatricians, and neuropsychiatrists of lower franconia were asked to fill out a questionnaire regarding the ratio of 0-20 year old patients with psychiatric symptoms and their prescribing methods of psychopharmaca. Neuropsychiatrists treated less children and adolescents with psychiatric symptoms than pediatricians or general practitioners. Approximately 50% of the patients with psychiatric symptoms received psychopharmaca. The most frequently prescribed psychopharmaca were neuroleptics and antidepressants, followed by phytopharmaca with various ingredients, which were most frequently prescribed by general practitioners. The average duration of a psychopharmacotherapy was 9 weeks. A great deal of uncertainty regarding the prescription of psychopharmaca to children and adolescents has become evident. Despite the fact that an enuresis can not be diagnosed before the end of the 5th year, it was one of the most frequently treated symptom of the 2-5 year old children. On the other hand, approximately one third of all physicians principally do not treat children and adolescents with psychopharmaca.

Treatment with psychopharmaceuticals in childhood is controversial. From time to time, reports are brought by the press on excessive consumption of psychopharmaceuticals by children. It is shown that such press reports do not stand critical examination. The prescribing of such drugs in childhood requires great care, considerable knowledge and meticulous observance of indications. The most important indications are outlined. Psychiatric treatment in children and adolescents is always "multi-pronged".