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[儿童、青少年及智障受试者中精神药物的使用:综述]

[Use of psychotropic drugs in children, adolescents and subjects with intellectual disability: a review].

作者信息

Lazzeretti Lisa, Pracucci Chiara, Benni Laura, Godini Lucia, Talamba Gabriela Alina, Faravelli Carlo

机构信息

Dipartimento di Scienze Neurologiche e Psichiatriche, Università di Firenze.

出版信息

Riv Psichiatr. 2011 Jan-Feb;46(1):1-17.

Abstract

AIM

In children, adolescents and subjects with intellectual disability (ID), psychotropic drugs are being used in large and increasing quantities. The aim of this article is to review efficacy and safety evidences of psychotropic drugs use in the above-mentioned patients.

METHODS

A literature search on this argument was conducted on Medline electronic archives encompassing english-language and other languages publications.

RESULTS

In children, adolescents and subjects with ID, the use of antidepressants, antipsychotics and mood stabilizers, besides being effective for indications in psychiatric disorders of adults without ID, is proved to have good clinical efficacy in disorders which are characteristic of such patients categories, such as pervasive developmental disorders, disruptive behavior disorders and problem behaviours. In both patients populations non-medication based strategies should be considered first. The adverse effects profiles of psychotropic drugs administered in children, adolescents and subjects with ID seems to be different from the ones registered in adults without ID, thus particular caution and precautions are recommended.

DISCUSSION

Given the paucity of data (especially in the long term) and the metodological limitations of currently available researches, more studies are needed to develop scientific evidences able to guide practitioners in the use of psychotropic medications among childhood, adolescence and ID.

摘要

目的

在儿童、青少年以及智障患者中,精神药物的使用量巨大且呈上升趋势。本文旨在综述精神药物在上述患者中使用的有效性和安全性证据。

方法

在Medline电子数据库中对该主题进行文献检索,涵盖英文及其他语言的出版物。

结果

在儿童、青少年和智障患者中,除了对无智障的成年人的精神疾病适应症有效外,抗抑郁药、抗精神病药和心境稳定剂在这类患者特有的疾病,如广泛性发育障碍、破坏性行为障碍和问题行为中也被证明具有良好的临床疗效。在这两类患者群体中,应首先考虑非药物治疗策略。儿童、青少年和智障患者使用精神药物的不良反应情况似乎与无智障成年人中记录的情况不同,因此建议格外谨慎并采取预防措施。

讨论

鉴于数据匮乏(尤其是长期数据)以及现有研究的方法学局限性,需要更多研究来提供科学证据,以指导从业者在儿童期、青少年期和智障患者中使用精神药物。

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