Work

Pharmacological and nonpharmacological interventions for adolescent irritability: a systematic review and meta-analysis

Year: 2025

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: This systematic review and meta-analysis aims to synthesize evidence on the efficacy of current pharmacological and nonpharmacological interventions for irritability management in children and adolescents. In total, 1144 abstracts were reviewed; 58 randomized controlled trials were selected for meta-analysis. A random-effects model was used, with a subgroup analysis to assess the effects of study design and intervention type. Antipsychotics—particularly in combination regimens (Cohen’s d = − 0.72) demonstrated the most significant efficacy in alleviating irritability among children and adolescents, with risperidone being the predominant agent (27/30 studies). Among non-pharmacological interventions, Parent Training (PT, d = − 0.45) constituted the most extensively studied approach despite moderate efficacy, while Low-Level Laser Therapy (LLLT, d = − 1.89) and Dialectical Behavior Therapy for Children (DBT-C, d = − 1.04) showed higher effect magnitudes yet were supported by limited evidence from single small-scale trials. This meta-analysis provides a comprehensive review of interventions targeting persistent non-episodic irritability in children and adolescents with various psychiatric disorders. Pharmacological interventions demonstrated the strongest effects, particularly antipsychotics and combination pharmacotherapy, though antipsychotics necessitate vigilance regarding adverse reactions. Nonpharmacological approaches remain first-line for preschoolers, with LLLT and DBT-C showing promising efficacy that merits comparative studies against PT.

Source: Discover Medicine

DOI: 10.1007/s44337-025-00472-w