Degrauw Roosje S, Li Jason Z, Gilbert Donald L
Tourette Syndrome and Movement Disorders Clinics, Division of Neurology, Cincinnati Children's Hospital Medical Center and the University of Cincinnati School of Medicine, Cincinnati, Ohio, USA.
Pediatr Neurol. 2009 Sep;41(3):183-6. doi: 10.1016/j.pediatrneurol.2009.04.002.
A known risk of neuroleptic medications is weight gain, but few studies have estimated long-term effects in childhood. This study evaluated effects of neuroleptics on body mass index for age and sex (body mass index Z scores) in a matched cohort of neuroleptic-treated (n = 16) and nonneuroleptic-treated (n = 29) children and adolescents with Tourette syndrome. Growth parameters were assessed in 45 children, aged 5-15 years, treated for an average of 3 years (range, 1-6) with low doses of pimozide or risperidone. Effects of neuroleptic treatment, age, duration, and treatment x duration interactions on changes in Z score were assessed with regression, and time course of changes was modeled using repeated measures analysis of variance. Although the mean first-year weight gain differed significantly (13.5 kg neuroleptic vs 3.2 kg nonneuroleptic), the longterm Z score changes did not (0.3 vs 0.1; F(4,44) = 0.87, P = 0.49). Repeated measures analysis of Z scores differed significantly by treatment (F(3,77.6) = 6.34, P = 0.0007), related to first-year changes only. In children and adolescents with Tourette syndrome treated for longer than 1 year with neuroleptics, weight gain is not necessarily excessive.
已知抗精神病药物的一个风险是体重增加，但很少有研究评估其对儿童的长期影响。本研究评估了抗精神病药物对患有图雷特综合征的接受抗精神病药物治疗的儿童和青少年（n = 16）与未接受抗精神病药物治疗的儿童和青少年（n = 29）的年龄和性别标准化体重指数（体重指数Z评分）的影响。对45名年龄在5至15岁、平均接受低剂量匹莫齐特或利培酮治疗3年（范围为1至6年）的儿童的生长参数进行了评估。使用回归分析评估抗精神病药物治疗、年龄、治疗时长以及治疗与治疗时长的交互作用对Z评分变化的影响，并使用重复测量方差分析对变化的时间进程进行建模。尽管第一年的平均体重增加有显著差异（接受抗精神病药物治疗的儿童增加13.5千克，未接受治疗的儿童增加3.2千克），但长期的Z评分变化并无显著差异（分别为0.3和0.1；F(4,44) = 0.87，P = 0.49）。Z评分的重复测量分析在治疗组间有显著差异（F(3,77.6) = 6.34，P = 0.0007），且仅与第一年的变化有关。在患有图雷特综合征且接受抗精神病药物治疗超过1年的儿童和青少年中，体重增加不一定过多。
