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长效注射利培酮在儿童和青少年中的疗效、不良反应和药物依从性。

Effectiveness, Adverse Effects and Drug Compliance of Long-Acting Injectable Risperidone in Children and Adolescents.

机构信息

Child and Adolescent Psychiatry Department, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey.

Child and Adolescent Psychiatry Department, Ankara Pediatric and Pediatric Hematology Oncology Training and Research Hospital, Ankara, Turkey.

出版信息

Clin Drug Investig. 2017 Oct;37(10):947-956. doi: 10.1007/s40261-017-0555-7.

Abstract

BACKGROUND AND OBJECTIVES

Although the use of oral risperidone in children and adolescents has been well studied, there is little information on the intramuscular use of long-acting injectable risperidone (LAIR). The aims of this study were to investigate the effectiveness and adverse effects of LAIR in children and adolescents with conduct disorder, bipolar disorder, and schizophrenia.

METHODS

In total, 42 patients (age range 12-17 years) who were non-adherent to oral antipsychotic drugs, received 25 mg of LAIR intramuscularly every 2 weeks. The drug was administered at least four times and up to 66 times (median drug use: 9.50 times). The effectiveness and adverse effects of the treatment were examined.

RESULTS

There was an improvement in 13 (92.8%) of the 14 patients diagnosed with bipolar disorder, in 25 (78.1%) of 32 patients diagnosed with conduct disorder and in one (50%) of two patients diagnosed with schizophrenia. Six patients had comorbid conduct disorder and bipolar disorder. Totally, 81% of the patients improved with LAIR. Weight-gain, daytime somnolence, muscle stiffness and spasms, impaired concentration, and fatigue were the most common side effects through the whole sample. Menstrual problems were common in girls. In the study, 57.1% of the patients continued to receive their injections regularly until the end of the treatment, under physician control. A total of 16.7% discontinued the treatment due to non-adherence. The LAIR treatment was terminated in 26.2% of the patients, due to weight-gain, dystonia, and galactorrhea.

CONCLUSIONS

In children and adolescents with conduct disorder, bipolar disorder and schizophrenia who show noncompliance with oral drugs, LAIR may improve treatment compliance. LAIR is a reliable treatment in terms of its effectiveness. Weight-gain, dystonia, and galactorrhea were the adverse effects that were responsible for LAIR treatment cessation.

摘要

背景和目的

虽然已经对儿童和青少年使用利培酮口服液进行了充分的研究,但关于长效注射用利培酮(LAIR)的使用信息却很少。本研究的目的是调查 LAIR 对患有品行障碍、双相情感障碍和精神分裂症的儿童和青少年的疗效和不良反应。

方法

共有 42 名(年龄 12-17 岁)不依从口服抗精神病药物的患者接受了 25mg 的 LAIR 肌内注射,每 2 周 1 次。该药物的使用次数至少为 4 次,最多 66 次(中位数药物使用次数:9.50 次)。对治疗的疗效和不良反应进行了检查。

结果

14 名双相情感障碍患者中有 13 名(92.8%)、32 名品行障碍患者中有 25 名(78.1%)和 2 名精神分裂症患者中有 1 名(50%)的病情得到改善。6 名患者同时患有品行障碍和双相情感障碍。共有 81%的患者通过 LAIR 治疗得到改善。整个样本中最常见的不良反应是体重增加、白天嗜睡、肌肉僵硬和痉挛、注意力不集中和疲劳。女孩常见的是月经问题。在研究中,57.1%的患者在医生的控制下继续定期接受注射,直到治疗结束。共有 16.7%的患者因不依从而停止治疗。由于体重增加、肌张力障碍和溢乳,共有 26.2%的患者停止了 LAIR 治疗。

结论

对于不依从口服药物的品行障碍、双相情感障碍和精神分裂症儿童和青少年,LAIR 可能会提高治疗的依从性。LAIR 在疗效方面是一种可靠的治疗方法。体重增加、肌张力障碍和溢乳是导致 LAIR 治疗停止的不良反应。

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