Bramness Jørgen G, Grøholt Berit, Engeland Anders, Furu Kari
Department of Pharmacoepidemiology, Division of Epidemiology, Norwegian Institute of Public Health, NO-0881 Oslo, Norway.
J Affect Disord. 2009 Oct;117(3):208-11. doi: 10.1016/j.jad.2009.01.006. Epub 2009 Feb 3.
There is an increasing awareness of bipolar disorder in children and adolescents. Our study aimed to explore how common the use of lithium, valproate and lamotrigine in psychiatric conditions in children and adolescents in Norway and to describe concomitant use of other psychotropic drugs.
The Norwegian Prescription Database (NorPD) captures all prescriptions given to individuals in ambulatory care. We investigated prescriptions for lithium, and for valproate and lamotrigine given for psychiatric conditions to children and adolescents under the age of 18 years from 2004 till 2007. We also studied other prescriptions for psychotropic drugs given to the same patients during the period. A comparison was made with the users of ADHD medication.
The number below 18 years treated with lithium, valproate or lamotrigine rose from 323 (0.03%) in 2004 till 454 (0.04%) in 2007. Lamotrigine increased most rapidly and lithium was most infrequently used. The users of the three drugs had often also tried antidepressants (14-42%) and atypical antipsychotics (21-51%), but true concomitant use was rarer (7-20% and 16-43% respectively). The users of ADHD medication had a much lower use of other psychotropic drugs, but quite a few users of lithium, valproate and lamotrigine had tried ADHD medication (20-26%) and even used these drugs concomitantly (15-21%).
NorPD does not include diagnoses, and we do not know if the drugs dispensed were actually used.
Overall there has been a slight increase in the use of lamotrigine in Norway during the last four years, most likely prescribed as a mood stabilizer in bipolar disorders. Still the use among the under 14-year-olds is rare in Norway.
儿童和青少年双相情感障碍的认知度日益提高。我们的研究旨在探讨挪威儿童和青少年在精神疾病治疗中使用锂盐、丙戊酸盐和拉莫三嗪的普遍程度，并描述其他精神药物的联合使用情况。
挪威处方数据库（NorPD）记录了门诊患者的所有处方。我们调查了2004年至2007年期间18岁以下儿童和青少年因精神疾病开具的锂盐、丙戊酸盐和拉莫三嗪的处方。我们还研究了同期给予这些患者的其他精神药物处方。并与多动症药物使用者进行了比较。
接受锂盐、丙戊酸盐或拉莫三嗪治疗的18岁以下患者数量从2004年的323人（0.03%）增至2007年的454人（0.04%）。拉莫三嗪使用增长最为迅速，锂盐使用最少。这三种药物的使用者还经常尝试使用抗抑郁药（14 - 42%）和非典型抗精神病药（21 - 51%），但真正联合使用的情况较少（分别为7 - 20%和16 - 43%）。多动症药物使用者使用其他精神药物的比例要低得多，但相当一部分锂盐、丙戊酸盐和拉莫三嗪的使用者曾尝试使用多动症药物（20 - 26%），甚至联合使用过这些药物（15 - 21%）。
NorPD不包括诊断信息，我们也不知道所配发的药物是否实际被使用。
总体而言，过去四年挪威拉莫三嗪的使用略有增加，很可能是作为双相情感障碍的心境稳定剂开具的。不过在挪威14岁以下儿童中的使用仍然很少。
