Duhig Michael J, Saha Sukanta, Scott James G
Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland, Australia.
J Paediatr Child Health. 2013 Jan;49(1):19-26. doi: 10.1111/j.1440-1754.2011.02200.x. Epub 2011 Nov 3.
This study aims to review the evidence for the efficacy of risperidone in the treatment of disruptive behavioural disorders (DBDs) in children and adolescents. Established databases were searched using the terms 'Risperidone and efficacy and children' and 'Risperidone and efficacy and adolescents'. Randomised, double-blind controlled studies were retained for analysis. Janseen-Cilag was contacted to identify any unpublished studies. Quality of studies was measured using Jadad scores. Seven studies of 657 subjects with a mean age of 9.9 years (SD= 2.0) (range 4-18 years) were identified. Only one study was judged to use the highest quality of methodology according to the Jadad score. Patients with DBD who were treated with risperidone showed clinical improvement compared with placebo. Weight gain, somnolence and gastrointestinal complaints were common. Risperidone was found to be efficacious in reducing symptoms in children and adolescents with DBD. However, studies were mostly of short duration and had deficiencies in the descriptions of blinding and randomisation. Research using rigorous methodology examining the long-term outcomes of efficacy and safety are required to inform clinicians and families of the therapeutic benefits and risks of risperidone in this clinical population.
本研究旨在综述利培酮治疗儿童和青少年破坏性行为障碍(DBD)疗效的证据。使用“利培酮、疗效、儿童”以及“利培酮、疗效、青少年”等检索词对既定数据库进行检索。保留随机双盲对照研究进行分析。联系杨森-西拉格公司以确定是否存在未发表的研究。使用雅达评分衡量研究质量。共识别出7项研究,涉及657名受试者,平均年龄为9.9岁(标准差=2.0)(范围4 - 18岁)。根据雅达评分,仅1项研究被判定采用了最高质量的方法。与安慰剂相比,接受利培酮治疗的DBD患者临床症状有所改善。体重增加、嗜睡和胃肠道不适较为常见。发现利培酮对减轻DBD儿童和青少年的症状有效。然而,研究大多持续时间较短,在盲法和随机化描述方面存在缺陷。需要采用严格方法进行研究,以考察疗效和安全性的长期结果,从而让临床医生和家庭了解利培酮在该临床人群中的治疗益处和风险。