de Leon Jose, Greenlee Brian, Barber Jack, Sabaawi Mohamed, Singh Nirbhay N
University of Kentucky Mental Health Research Center, Lexington, KY 40508, USA.
Res Dev Disabil. 2009 Jul-Aug;30(4):613-69. doi: 10.1016/j.ridd.2008.10.010. Epub 2008 Dec 11.
New generation antipsychotic (NGA) drugs introduced to the US market after clozapine (aripiprazole, olanzapine, paliperidone, quetiapine, risperidone, and ziprasidone) are frequently used in individuals with intellectual disabilities (ID). However, there is very limited research to fully establish evidence-based or personalized medicine approaches for their use in this population. These guidelines take a pragmatic approach to establishing frameworks for their use by utilizing the prescribing information and reviewing the available literature on other relevant neuropsychiatric disorders. In the absence of expert consensus guidance and well-controlled comparison trials, we present a set of guidelines to inform initiation, dosing and monitoring of use in adults. Further, in these guidelines we provide practical information on drug-drug interactions and adverse drug reactions, and a brief review of discontinuation syndromes, potential for abuse, use during pregnancy and cost considerations. We also provide drug utilization review forms for each NGA to facilitate implementation of these guidelines, these guidelines provide a practical and necessary resource for practitioners treating psychiatric disorders and challenging behaviors in adult individuals with ID.
在氯氮平之后引入美国市场的新一代抗精神病药物（NGA，包括阿立哌唑、奥氮平、帕利哌酮、喹硫平、利培酮和齐拉西酮）常用于智障人士（ID）。然而，关于在该人群中使用这些药物以充分确立循证或个性化医疗方法的研究非常有限。这些指南采用务实的方法，通过利用处方信息并回顾其他相关神经精神疾病的现有文献来建立使用框架。在缺乏专家共识指导和严格对照比较试验的情况下，我们提出一套指南，为成人用药的起始、剂量确定和监测提供参考。此外，在这些指南中，我们提供了关于药物相互作用和药物不良反应的实用信息，以及对停药综合征、滥用可能性、孕期使用和成本考虑的简要回顾。我们还为每种NGA提供了药物利用审查表，以促进这些指南的实施，这些指南为治疗成年智障人士精神疾病和挑战行为的从业者提供了实用且必要的资源。
