Clavenna Antonio, Rossi Elisa, Derosa Marisa, Bonati Maurizio
Laboratory for Mother and Child Health, Mario Negri Institute for Pharmacological Research, Via Eritrea 62, 20157, Milan, Italy.
Eur J Pediatr. 2007 Apr;166(4):339-47. doi: 10.1007/s00431-006-0244-7. Epub 2006 Oct 7.
The evidence of psychotropic drug safety and efficacy in the pediatric population is scant and widely debated. Yet, the prescription prevalence and incidence are increasing. A drug utilization study, based on a multiregional prescription database was therefore carried out in a sample of 1,484,770 Italian children and adolescents younger than 18 years during the year 2004. Furthermore, the trend of psychotropic prescription prevalence was evaluated from 1998 to 2004. During 2004, 4,316 children and adolescents received psychotropic drugs (2.91 per thousand youths). Antidepressants were prescribed to 3,503 youths (2.36 per thousand), antipsychotics to 1,005 (0.68 per thousand), and lithium to 73 (0.05 per thousand). A total of 265 youths received drugs from more than one psychotropic class. The prevalence rate of psychotropic drug prescriptions increased with increasing age, with a statistically significant trend ([Formula: see text]; p<0.0001), and it increased in the period 1998-2004 with a statistically significant trend ([Formula: see text]; p<0.0001), reaching its highest value in 2002 (3.08 per thousand). The trend for antidepressants was similar ([Formula: see text]; p<0.0001), while the prevalence of antipsychotics did not increase.
Even though the prevalence of psychotropic drug prescriptions in Italian children is lower than that reported in other countries (e.g. United States, Canada, Netherlands, UK), the increase in antidepressant prescriptions raises some concerns. Data concerning safety and efficacy of these antidepressants in pediatrics are still limited and further studies are needed to guarantee evidence based therapeutic approaches in children, adolescents and their families.
关于精神药物在儿科人群中的安全性和有效性的证据很少，且存在广泛争议。然而，其处方流行率和发病率却在不断上升。因此，基于多地区处方数据库，对2004年1484770名18岁以下意大利儿童和青少年样本进行了一项药物利用研究。此外，还评估了1998年至2004年精神药物处方流行率的趋势。2004年期间，4316名儿童和青少年接受了精神药物治疗（每千名青少年中有2.91人）。3503名青少年开具了抗抑郁药（每千名中有2.36人），1005名开具了抗精神病药（每千名中有0.68人），73名开具了锂盐（每千名中有0.05人）。共有265名青少年接受了不止一类精神药物治疗。精神药物处方的流行率随年龄增长而增加，具有统计学显著趋势（[公式：见原文]；p<0.0001），并且在1998 - 2004年期间也有统计学显著增加趋势（[公式：见原文]；p<0.0001），在2002年达到最高值（每千名中有3.08人）。抗抑郁药的趋势类似（[公式：见原文]；p<0.0001），而抗精神病药的流行率没有增加。
尽管意大利儿童精神药物处方的流行率低于其他国家（如美国、加拿大、荷兰、英国）报告的水平，但抗抑郁药处方的增加引起了一些关注。关于这些抗抑郁药在儿科的安全性和有效性的数据仍然有限，需要进一步研究以确保为儿童、青少年及其家庭提供基于证据的治疗方法。
