儿童和青少年中抗抑郁药引起的激活反应：风险、识别与管理
Antidepressant-Induced Activation in Children and Adolescents: Risk, Recognition and Management.
作者信息
Luft Marissa J, Lamy Martine, DelBello Melissa P, McNamara Robert K, Strawn Jeffrey R
机构信息
Department of Psychiatry, University of Cincinnati, College of Medicine, Cincinnati, OH 45267-0559.
Department of Pediatrics, Division of Child & Adolescent Psychaitry, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229.
出版信息
Curr Probl Pediatr Adolesc Health Care. 2018 Feb;48(2):50-62. doi: 10.1016/j.cppeds.2017.12.001. Epub 2018 Jan 19.
Abstract
The tolerability of antidepressants is poorly characterized in children and adolescents with depressive and anxiety disorders. Among adverse events that affect the tolerability of antidepressants in youth is activation, a cluster of symptoms that represent a hyperarousal event characterized by impulsivity, restlessness, and/or insomnia. This cluster of symptoms was first identified as a side effect of selective serotonin and selective serotonin norepinephrine inhibitors (SSRIs and SSNRIs) in the early 1990s; however, activation remains poorly characterized in terms of prevalence, risk factors, and pathophysiology. This article describes the pathophysiology of antidepressant-related activation, predictors of activation and its clinical management in youth with depressive and anxiety disorders who are treated with antidepressant medications.
摘要
在患有抑郁和焦虑症的儿童及青少年中，抗抑郁药的耐受性特征尚不明确。影响青少年抗抑郁药耐受性的不良事件之一是激越，这是一组以冲动、坐立不安和/或失眠为特征的高度唤醒症状群。该症状群在20世纪90年代初首次被确定为选择性5-羟色胺再摄取抑制剂及5-羟色胺-去甲肾上腺素再摄取抑制剂（SSRI和SSNRI）的副作用；然而，在患病率、危险因素和病理生理学方面，激越的特征仍不明确。本文描述了在接受抗抑郁药物治疗的抑郁和焦虑症青少年中，与抗抑郁药相关的激越的病理生理学、激越的预测因素及其临床管理。
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