Teixeira Eduardo Henrique, Jacintho Antonio, Celeri Heloisa Valler, Dalgalarrondo Paulo
School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil.
Child and Adolescent Psychiatry Outpatient Unit, Hospital de Clínicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
Trends Psychiatry Psychother. 2013;35(3):151-9. doi: 10.1590/s2237-60892013000300002.
To review the literature about the use of atypical antipsychotics in the treatment of pathological aggression in children and adolescents.
The databases MEDLINE, SciELO, and LILACS were searched for publications in Portuguese or English from 1992 to August 2011 using the following keywords: mental disease, child, adolescent, treatment, atypical antipsychotic, aggressive behavior, aggression, and violent behavior.
Sixty-seven studies of good methodological quality and clinical interest and relevance were identified. Studies including children and adolescents were relatively limited, because few atypical antipsychotics have been approved by the Food and Drug Administration (FDA). All the medications included in this review (risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole and clozapine) have some effectiveness in treating aggression in children and adolescents, and choices should be based on clinical indications and side effects.
There are few studies about the effectiveness and safety of atypical antipsychotics for the pediatric population, and further randomized controlled studies with larger groups of patients and more diagnostic categories, such as severe conduct disorder and oppositional defiant disorder, should be conducted to confirm the results reported up to date and to evaluate the impact of long-term use.
回顾关于使用非典型抗精神病药物治疗儿童及青少年病理性攻击行为的文献。
在MEDLINE、SciELO和LILACS数据库中检索1992年至2011年8月期间以葡萄牙语或英语发表的文献，使用以下关键词：精神疾病、儿童、青少年、治疗、非典型抗精神病药物、攻击性行为、攻击、暴力行为。
确定了67项方法学质量良好且具有临床兴趣和相关性的研究。涉及儿童和青少年的研究相对有限，因为很少有非典型抗精神病药物获得美国食品药品监督管理局（FDA）的批准。本综述中纳入的所有药物（利培酮、奥氮平、喹硫平、齐拉西酮、阿立哌唑和氯氮平）在治疗儿童和青少年攻击行为方面均有一定疗效，应根据临床指征和副作用进行选择。
关于非典型抗精神病药物对儿科人群有效性和安全性的研究较少，应开展更多针对更大患者群体且涵盖更多诊断类别（如重度品行障碍和对立违抗障碍）的随机对照研究，以证实目前报道的结果，并评估长期使用的影响。
