Ho Josephine, Panagiotopoulos Constadina, McCrindle Brian, Grisaru Silviu, Pringsheim Tamara
The Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotics in Children (CAMESA) Guideline Project.
J Can Acad Child Adolesc Psychiatry. 2011 Aug;20(3):234-41.
Second generation antipsychotics (SGAs) are commonly associated with metabolic complications. These medications are being used more frequently for the treatment of mental health disorders in children, which has stimulated the need for creating formal guidelines on monitoring their safety and effectiveness. Previous guidelines have been developed for monitoring for metabolic and neurological complications. In order to assist practitioners who perform these monitoring procedures, we have created a complementary set of treatment recommendations if abnormal measurements or results are encountered.
To create evidence-based recommendations to assist in managing metabolic complications in children being treated with second generation antipsychotics.
A systematic review of the literature on metabolic complications of second generation antipsychotic medications in children was conducted. Members of the consensus group evaluated the information gathered from the systematic review of the literature and used a nominal group process to come to consensus on treatment recommendations. Wherever possible, references were made to existing guidelines on the evaluation and treatment of metabolic abnormalities in children.
Evidence-based recommendations are presented to assist in managing metabolic complications, including weight gain, increased waist circumference, elevation in cholesterol, triglycerides and glucose, liver function tests, abnormal thyroid studies, and elevation in prolactin.
The use of SGAs requires proper monitoring procedures. This treatment guideline provides guidance to clinicians on clinical management of metabolic complications if they occur.
第二代抗精神病药物（SGA）通常与代谢并发症相关。这些药物在儿童心理健康障碍治疗中的使用越来越频繁，这激发了制定关于监测其安全性和有效性的正式指南的需求。此前已制定了关于监测代谢和神经并发症的指南。为了帮助执行这些监测程序的从业者，我们制定了一套补充性的治疗建议，用于应对异常测量结果或检测结果。
制定基于证据的建议，以协助管理接受第二代抗精神病药物治疗的儿童的代谢并发症。
对关于第二代抗精神病药物在儿童中的代谢并发症的文献进行了系统综述。共识小组的成员评估了从文献系统综述中收集到的信息，并采用名义小组法就治疗建议达成共识。尽可能参考了关于儿童代谢异常评估和治疗的现有指南。
提出了基于证据的建议，以协助管理代谢并发症，包括体重增加、腰围增加、胆固醇、甘油三酯和血糖升高、肝功能检查、甲状腺检查异常以及催乳素升高。
使用第二代抗精神病药物需要适当的监测程序。本治疗指南为临床医生在代谢并发症发生时的临床管理提供指导。
