Are children and adolescents with psychiatric disorders therapeutic orphans?

Failure of incentive to investigation in infantile pharmaceutical trials ha s lead to insufficient supply with drugs within pediatrics and child- and a dolescent psychiatry in Germany. In practice, drugs that are approved for a dults are used to treat miners as a remedy. In many areas such "off label u se" has become the medical standard and is therefore owed by the doctor und er medical malpractice law. The principle of economy, that rules the law of public health insurance, forbids the prescription of drugs, that are not t ested. However, as miners have the right to equal protection, the principle of economy can not prohibit off label use to the detriment of miners. By v irtue of the European orphan drug direction we can expect an improvement of drug supply in the field of pediatrics and child- and adolescent psychiatr y in the long run. But meanwhile it would be unethical and unlawful to deny miners through restrictions on drug prescription a standard treatment, whe re the medical standard demands off label use of a pharmaceutical product.