儿童破坏性行为管理中的非典型抗精神病药物：安全性指南和建议。
Atypical antipsychotic medications in the management of disruptive behaviors in children: safety guidelines and recommendations.
机构信息
Department of Psychology, Mississippi State University, Mississippi State, MS 39762, USA.
出版信息
Clin Psychol Rev. 2011 Apr;31(3):465-71. doi: 10.1016/j.cpr.2010.11.005. Epub 2010 Nov 18.
Use of atypical antipsychotic medications (AAMs) in the treatment of disruptive behavior (DB) in children and adolescents has increased dramatically worldwide. However, with exception of using risperidone (i.e., for the management of irritability associated with autism, manic and mixed episodes associated with bipolar I disorder, and schizophrenia) and aripiprazole (i.e., for manic and mixed episodes associated with bipolar I disorder and schizophrenia), the Food and Drug Administration (FDA) has not approved the use of AAMs in children and adolescents. Although research on use of these medications in children and adolescents has increased, mechanisms of action and long-term outcomes remain poorly understood or unknown. Particularly concerning is that use of these medications in children and adolescents may impact cognitive, social, and physical development, as side effects may interfere with activities in their educational setting, peer networks, and recreational settings. Overall, AAMs frequently are prescribed off label, control DB through sedation rather than targeting actual causes of DB, and lead to many negative side effects with unknown long-term effects. Reconsidering the use of AAMs in managing DB is encouraged strongly.
在全球范围内，使用非典型抗精神病药物（AAMs）治疗儿童和青少年的破坏性行为（DB）的情况急剧增加。然而，除了使用利培酮（即，用于治疗自闭症相关的易激惹、双相 I 障碍相关的躁狂和混合发作以及精神分裂症）和阿立哌唑（即，用于双相 I 障碍相关的躁狂和混合发作以及精神分裂症）外，食品和药物管理局（FDA）尚未批准在儿童和青少年中使用 AAMs。尽管关于这些药物在儿童和青少年中的使用的研究有所增加，但作用机制和长期结果仍知之甚少或未知。特别令人担忧的是，这些药物在儿童和青少年中的使用可能会影响认知、社会和身体发育，因为副作用可能会干扰他们在教育环境、同伴网络和娱乐环境中的活动。总的来说，AAMs 经常被超说明书使用，通过镇静来控制 DB，而不是针对 DB 的实际原因，并且会导致许多未知长期影响的负面副作用。强烈鼓励重新考虑使用 AAMs 来治疗 DB。
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