Jain U, Birmaher B, Garcia M, Al-Shabbout M, Ryan N
J Child Adolesc Psychopharmacol. 1992 Winter;2(4):259-65. doi: 10.1089/cap.1992.2.259.
ABSTRACT The charts of 31 hospitalized children and adolescents (ages 9-18 years) with major mood disorders were retrospectively reviewed to examine the efficacy and side effects of treatment with fluoxetine. After treatment for a mean duration of 35 days, clinical improvement was seen in 74% of these patients; 54% had "much" to "very much" improvement as measured by the Clinical Global Impression scale (CGI). The most common adverse effects were hypomania-like symptoms (23%), irritability (19%), gastrointestinal upset (13%), and insomnia (13%). No EKG changes, blood pressure changes, anticholinergic symptoms, sedation, weight changes, or seizures were observed. None of the patients experienced an increase in suicidal or parasuicidal behavior. Discontinuation of the fluoxetine treatment occurred in 28% of cases, most commonly because of increasing irritability and hypomania-like symptoms. The hypomania-like effects included a constant sense of silliness, increased activity, poor sleep, increased energy, an increase in the stream of thoughts (racing thoughts), or socially intrusive or obnoxious behavor. Fluoxetine triggered symptoms suggestive of hypomania in all four of the depressive bipolar patients.
摘要 对31例患有严重情绪障碍的住院儿童及青少年（年龄9 - 18岁）的病历进行回顾性分析，以研究氟西汀治疗的疗效及副作用。经过平均35天的治疗，74%的患者有临床改善；根据临床总体印象量表（CGI）评定，54%的患者有“明显”至“非常明显”的改善。最常见的不良反应为轻躁狂样症状（23%）、易激惹（19%）、胃肠道不适（13%）及失眠（13%）。未观察到心电图改变、血压变化、抗胆碱能症状、镇静作用、体重变化或癫痫发作。无一例患者出现自杀或准自杀行为增加。28%的病例停用了氟西汀治疗，最常见的原因是易激惹和轻躁狂样症状加重。轻躁狂样效应包括持续的愚蠢感、活动增加、睡眠不佳、精力增加、思维奔逸，或社交上的侵扰性或令人讨厌的行为。氟西汀在所有4例抑郁双相患者中引发了提示轻躁狂的症状。
