Barzman Drew H, DelBello Melissa P, Forrester Jacob J, Keck Paul E, Strakowski Stephen M
Children's Hospital Medical Center, Division of Child and Adolescent Psychiatry, Cincinnati, Ohio 45229-3039, USA.
J Child Adolesc Psychopharmacol. 2007 Aug;17(4):503-9. doi: 10.1089/cap.2007.5124.
Our primary objective was to evaluate the effectiveness and tolerability of intramuscular ziprasidone for impulsivity and agitation in psychiatrically hospitalized children and adolescents. Our secondary objective was to examine demographic and clinical factors associated with treatment response.
We conducted a retrospective chart review of children and adolescents admitted to Cincinnati Children's Hospital Medical Center (CCHMC) psychiatric units between January 1, 2002, and July 11, 2005, who received intramuscular ziprasidone. Medical records were reviewed to determine demographic and clinical information as well as tolerability and effectiveness of ziprasidone. The Behavioral Activity Rating Scale (BARS) was used retrospectively to assess clinical response. Regression analyses were performed to evaluate the effect of demographic factors (age, gender, and ethnicity) and primary psychiatric diagnoses on treatment response. Electrocardiogram (ECG) data was inadequate.
Fifty nine children and adolescents received a total of 77 injections of intramuscular ziprasidone for acute agitation. The mean +/- SD BARS score decreased from 6.5 +/- 0.7 to 3.1 +/- 1.3. The most common side effect was drowsiness or falling asleep (n = 46, 60%). Three (4%) could not be roused after the injection.
Intramuscular ziprasidone may be helpful for agitation but often caused oversedation. Safety data, including ECGs, is needed in controlled prospective studies.
我们的主要目的是评估肌内注射齐拉西酮对精神科住院儿童及青少年冲动和激越症状的有效性及耐受性。次要目的是研究与治疗反应相关的人口统计学和临床因素。
我们对2002年1月1日至2005年7月11日期间入住辛辛那提儿童医院医疗中心（CCHMC）精神科病房且接受肌内注射齐拉西酮的儿童及青少年进行了回顾性病历审查。审查病历以确定人口统计学和临床信息以及齐拉西酮的耐受性和有效性。回顾性地使用行为活动评定量表（BARS）评估临床反应。进行回归分析以评估人口统计学因素（年龄、性别和种族）及主要精神科诊断对治疗反应的影响。心电图（ECG）数据不足。
59名儿童及青少年共接受了77次肌内注射齐拉西酮以治疗急性激越。平均±标准差BARS评分从6.5±0.7降至3.1±1.3。最常见的副作用是嗜睡或入睡（n = 46，60%）。3例（4%）注射后无法唤醒。
肌内注射齐拉西酮可能有助于缓解激越，但常导致过度镇静。在对照性前瞻性研究中需要包括心电图在内的数据以确保安全。
