Jerrell Jeanette M, Hwang Te-Long, Livingston Timothy S
Department of Neuropsychiatry, University of South Carolina School of Medicine, Columbia, SC 29203, USA.
J Child Neurol. 2008 Dec;23(12):1392-9. doi: 10.1177/0883073808319070. Epub 2008 Sep 4.
A retrospective cohort design using medical and pharmacy claims from one state's Medicaid program compared incidence rates for neurological adverse events associated with antipsychotic use in 4140 youths prescribed antipsychotic medications and an untreated sample of 4500 youths, January 1998 to December 2005. The treated cohort evinced a higher prevalence of involuntary movements, sedation, and seizures. The odds of incident involuntary movements were significantly higher for those taking aripiprazole, risperidone, haloperidol, and multiple antipsychotics. The odds of incident seizures were greater for those taking risperidone, multiple antipsychotics, and serotonin-specific reuptake inhibitors. The odds of incident sedation were greater for those taking ziprasidone, risperidone, quetiapine, multiple antipsychotics, and serotonin-specific reuptake inhibitors. Exposure to risperidone, multiple antipsychotics, and serotonin-specific reuptake inhibitors consistently confers a higher risk of developing a range of neurological adverse events in young patients, especially those with preexisting central nervous system, mental retardation, or cardiovascular disorders.
采用回顾性队列设计，利用某州医疗补助计划中的医疗和药房理赔数据，比较了1998年1月至2005年12月期间4140名使用抗精神病药物的青少年和4500名未接受治疗的青少年样本中与抗精神病药物使用相关的神经不良事件的发生率。接受治疗的队列中不自主运动、镇静和癫痫发作的患病率较高。服用阿立哌唑、利培酮、氟哌啶醇和多种抗精神病药物的患者发生不自主运动的几率显著更高。服用利培酮、多种抗精神病药物和5-羟色胺特异性再摄取抑制剂的患者发生癫痫发作的几率更大。服用齐拉西酮、利培酮、喹硫平、多种抗精神病药物和5-羟色胺特异性再摄取抑制剂的患者发生镇静的几率更大。接触利培酮、多种抗精神病药物和5-羟色胺特异性再摄取抑制剂持续会使年轻患者，尤其是那些已有中枢神经系统疾病、智力障碍或心血管疾病的患者，发生一系列神经不良事件的风险更高。
