Jensen Peter S, Buitelaar Jan, Pandina Gahan J, Binder Carin, Haas Magali
Center for the Advancement of Children's Mental Health, Columbia University, New York State Psychiatric Institute, New York, NY, USA.
Eur Child Adolesc Psychiatry. 2007 Mar;16(2):104-20. doi: 10.1007/s00787-006-0580-1. Epub 2006 Oct 30.
We aimed to provide a descriptive review of treatment studies of atypical antipsychotics in paediatric psychiatric disorders. A systematic review of the literature used Medline and EMBASE databases to identify clinical trials of atypical antipsychotics in children and adolescents between 1994 and 2006. Trials were limited to double-blind studies and open-label studies of > or = 8 weeks duration that included > or = 20 patients. Nineteen double-blind and 22 open-label studies were identified. Studies included use of clozapine, olanzapine, quetiapine, risperidone, and ziprasidone in the treatment of disruptive behavioural disorders (DBDs), pervasive developmental disorders (PDDs), tic disorder, psychotic disorders, and mania. These medications generally reduced the severity of a variety of psychiatric symptoms in children and adolescents. Less frequent adverse events included extrapyramidal symptoms, hyperglycaemia and diabetes, and endocrine effects. The review of published scientific data suggests that most of the atypical antipsychotics, excluding clozapine, have a favourable risk/benefit profile and effectively reduce disabling behaviours in paediatric psychiatric patients. While there is a body of evidence published of treatment of DBDs and PDDs, there is a lack of controlled data to guide clinical practice for the use of atypical antipsychotics for paediatric psychotic disorders and bipolar disorder. While there have been studies with duration up to 2 years, no definitive data are available that suggest long-term safety; additional studies are warranted.
我们旨在对非典型抗精神病药物治疗儿童精神疾病的研究进行描述性综述。通过对文献进行系统回顾，利用医学索引数据库（Medline）和荷兰医学文摘数据库（EMBASE）来识别1994年至2006年间有关儿童和青少年使用非典型抗精神病药物的临床试验。试验限于双盲研究以及持续时间≥8周且纳入≥20名患者的开放标签研究。共识别出19项双盲研究和22项开放标签研究。这些研究包括使用氯氮平、奥氮平、喹硫平、利培酮和齐拉西酮治疗破坏性行为障碍（DBD）、广泛性发育障碍（PDD）、抽动障碍、精神障碍和躁狂症。这些药物通常能减轻儿童和青少年各种精神症状的严重程度。较不常见的不良事件包括锥体外系症状、高血糖和糖尿病以及内分泌影响。对已发表科学数据的综述表明，除氯氮平外，大多数非典型抗精神病药物具有良好的风险/效益比，并能有效减少儿科精神疾病患者的致残行为。虽然有大量关于治疗DBD和PDD的证据发表，但缺乏对照数据来指导非典型抗精神病药物用于儿科精神障碍和双相情感障碍的临床实践。虽然有持续时间长达2年的研究，但尚无明确数据表明其长期安全性；需要进行更多研究。
