Department of Psychiatry, Queens University, Kingston Ontario.
Mood Disorders Center of Ottawa, Ottawa Ontario.
Pharmacopsychiatry. 2018 Sep;51(5):189-193. doi: 10.1055/a-0575-4179. Epub 2018 Feb 28.
There is a resurgence of interest in lithium treatment of bipolar disorders in part related to its unique anti-suicidal and neuroprotective effects.
This is a narrative review of key studies pertaining to the effectiveness and tolerability of lithium treatment in pediatric populations.
Evidence supports that lithium is an effective and generally well-tolerated acute treatment for pediatric mania compared to placebo. Lithium may be less effective than risperidone for treating chronic mixed/manic symptoms in young children but comparable to anticonvulsants. However, in comparison, risperidone was associated with higher weight gain and prolactin levels. There is a lack of evidence inform maintenance treatment in children who benefit from lithium. Other indications that require further study include treatment of refractory or recurrent major depression in children at confirmed familial risk of bipolar disorder, as well as the treatment of acute suicidal ideation/behavior and refractory aggression.
There is inadequate data about the full variety of benefit and tolerability of lithium treatment in pediatric patients. However, given the potential for protection against suicide and neurotoxic effects of illness, further studies should be a priority.
由于锂具有独特的抗自杀和神经保护作用，人们对其治疗双相情感障碍的兴趣再度高涨。
这是一篇关于锂在儿科人群中的疗效和耐受性的关键研究的叙述性综述。
有证据表明，与安慰剂相比，锂在治疗儿童躁狂症方面是一种有效且通常耐受性良好的急性治疗方法。锂可能不如利培酮治疗幼儿的慢性混合/躁狂症状有效，但与抗惊厥药相当。然而，相比之下，利培酮与更高的体重增加和催乳素水平相关。对于从锂治疗中受益的儿童，缺乏关于维持治疗的证据。其他需要进一步研究的适应症包括治疗已确诊的双相情感障碍家族风险的儿童的难治性或复发性重度抑郁症，以及治疗急性自杀意念/行为和难治性攻击行为。
关于锂在儿科患者中的治疗效果和耐受性的全部情况，数据不足。然而，鉴于其对预防自杀和疾病的神经毒性作用的潜在保护作用，应优先进行进一步的研究。
