Jensen P S, Bhatara V S, Vitiello B, Hoagwood K, Feil M, Burke L B
Child and Adolescent Research, NIMH, Bethesda, MD 20892-9669, USA.
J Am Acad Child Adolesc Psychiatry. 1999 May;38(5):557-65. doi: 10.1097/00004583-199905000-00017.
To determine national pediatric prescribing practices for psychotropic agents and to examine these practices in view of the available evidence concerning their safety and efficacy in this age group.
Prescribing data from 2 national databases based on surveys of office-based medical practices were determined and reviewed vis-à-vis available safety and efficacy evidence.
Data indicate that levels of psychotropic prescribing in children and adolescents are greatest for stimulants, resulting in nearly 2 million office visits and 6 million drug "mentions" in 1995. Selective serotonin reuptake inhibitors were the second most prescribed psychotropic agents, while anticonvulsant mood stabilizers (prescribed for a psychiatric reason), tricyclic antidepressants, central adrenergic agonists, antipsychotics, benzodiazepines, and lithium were also prescribed for a substantial number of office visits. Comparison of prescribing frequencies with available safety and efficacy data indicates significant gaps in knowledge for commonly used agents.
Most psychotropic agents require further sustained study to ensure appropriate health care expenditures and vouchsafe children's safety. Recommendations for researchers, parents, federal agencies, and industry are offered as a means to accelerate the pace of research progress.
确定全国儿童精神药物的处方习惯，并根据该年龄组药物安全性和有效性的现有证据审视这些习惯。
从两个基于门诊医疗实践调查的全国性数据库中获取处方数据，并对照现有的安全性和有效性证据进行审查。
数据表明，儿童和青少年中精神药物处方量最多的是兴奋剂，1995年因兴奋剂就诊近200万人次，药物“提及”达600万次。选择性5-羟色胺再摄取抑制剂是第二大最常处方的精神药物，而抗惊厥心境稳定剂（用于精神科原因）、三环类抗抑郁药、中枢肾上腺素能激动剂、抗精神病药、苯二氮䓬类药物和锂盐也用于大量门诊。将处方频率与现有安全性和有效性数据进行比较表明，常用药物在认知方面存在显著差距。
大多数精神药物需要进一步持续研究，以确保合理的医疗保健支出并保障儿童安全。为研究人员、家长、联邦机构和制药行业提供了建议，作为加快研究进展步伐的一种手段。
