Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, 3555 Harden St Ext, 15 Medical Park, Ste 301, Columbia, SC 29203, USA.
J Natl Med Assoc. 2010 May;102(5):375-83. doi: 10.1016/s0027-9684(15)30572-1.
To identify the types of adverse events associated with psychotropic treatment in African American children and adolescents, analyses were performed using a retrospective cohort design evaluating medical and pharmacy claims from South Carolina's Medicaid program covering outpatient and inpatient medical services and medication prescriptions between January 1996 and December 2005. All children and adolescents prescribed 1 of 7 antipsychotic medications, 1 of 26 antidepressants, or 1 of 3 antimanic agents, and a random sample of 4500 children not treated with psychotropic medications were identified. Antipsychotics were more closely associated with the development of obesity and sexual/reproductive adverse events in African American patients. In the antidepressant-treated cohort, incident obesity/weight gain, dyslipidemia, and type 2 diabetes mellitus were more likely in African American patients. Obesity/weight gain, dyslipidemia, and sexual/reproductive problems were significantly more likely for African American patients treated with antimanic agents. Practitioners need to carefully weigh the risks/benefits of prescribing all types of psychotropic agents to African American children, taking into consideration preexisting/comorbid conditions or individual risk factors for adverse reactions, especially when multiple medications are prescribed.
为了确定与非裔美国儿童和青少年的精神药物治疗相关的不良事件类型,我们采用回顾性队列设计,对南卡罗来纳州医疗补助计划(Medicaid program)的医疗和药房数据进行了分析,该计划涵盖了 1996 年 1 月至 2005 年 12 月期间的门诊和住院医疗服务以及药物处方。所有接受了 7 种抗精神病药物、26 种抗抑郁药或 3 种抗躁狂药物中的 1 种处方的儿童和青少年,以及随机抽取的 4500 名未接受精神药物治疗的儿童均被纳入分析。抗精神病药物与非裔美国患者肥胖和生殖/性功能不良事件的发生密切相关。在接受抗抑郁药治疗的队列中,非裔美国患者更容易发生肥胖/体重增加、血脂异常和 2 型糖尿病。肥胖/体重增加、血脂异常和生殖/性功能障碍在接受抗躁狂药物治疗的非裔美国患者中更为常见。临床医生在为非裔美国儿童开具所有类型的精神药物时,需要仔细权衡利弊,考虑到不良反应的潜在共病或个体风险因素,尤其是在开具多种药物的情况下。