Hässler Frank, Dück Alexander, Jung Martin, Reis Olaf
1 Department of Child and Adolescent Psychiatry, University Medicine of Rostock , Rostock, Germany .
J Child Adolesc Psychopharmacol. 2014 Dec;24(10):579-81. doi: 10.1089/cap.2014.0066.
Disruptive or challenging behavior problems pose a threat to children and adolescents with intellectual disabilities and their caregivers. Psychopharmacological treatment is mostly studied with new-generation antipsychotics and has been criticized for adverse side effects. This study examined the effect of the classic antipsychotic zuclopenthixol.
A total of 39 boys (ages 8.0-17.11 years) with learning disabilities were included and examined for a response to zuclopenthixol during a 6 week period of open label treatment. Doses started low and were adapted individually. From responders, zuclopenthixol was randomly withdrawn for 12 weeks. Responses to withdrawal were observed by external raters using the Modified Overt Aggression Scale.
Of all patients included into the study, 15 were not randomized because of insufficient therapeutic effect, adverse event, or noncompliance. Kaplan-Meier estimations showed less aggressive behavior problems for the continuing subgroup (n=9) than in the placebo group (n=15). Individual doses stayed <10 mg/day.
Zuclopenthixol proved to be effective in reducing challenging behavior in boys even at low doses.
破坏性行为或具有挑战性的行为问题对智障儿童和青少年及其照顾者构成威胁。心理药物治疗大多使用新一代抗精神病药物进行研究，且因副作用而受到批评。本研究考察了经典抗精神病药物珠氯噻醇的疗效。
共纳入39名有学习障碍的男孩（年龄8.0 - 17.11岁），在为期6周的开放标签治疗期间检查他们对珠氯噻醇的反应。剂量从低开始，并根据个体情况调整。对有反应者，将珠氯噻醇随机撤药12周。外部评估者使用改良的公开攻击量表观察撤药反应。
纳入研究的所有患者中，15名因治疗效果不佳﹑不良事件或不依从未被随机分组。卡普兰 - 迈耶估计显示，持续用药亚组（n = 9）的攻击性行为问题比安慰剂组（n = 15）少。个体剂量保持在<10毫克/天。
即使低剂量使用，珠氯噻醇也被证明能有效减少男孩的挑战性 行为。
