Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX; Department of Pediatrics, Baylor College of Medicine, Houston, TX.
Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA.
J Pediatr. 2018 Oct;201:245-251. doi: 10.1016/j.jpeds.2018.05.040. Epub 2018 Jun 27.
To examine whether selective serotonin reuptake inhibitors (SSRIs) inhibit longitudinal growth in children and adolescents, particularly in the early stages of puberty, using a sample of convenience comprising risperidone-treated boys.
Data from four clinic-based studies in risperidone-treated 5- to 17-year-old boys with no general medical conditions were combined for this analysis. Anthropometric measurements and psychotropic treatment history were extracted from the medical and pharmacy records. Linear mixed effects regression analyses examined the association between SSRI use and change in age-sex-specific height and body mass index z scores, after adjusting for relevant confounders.
Risperidone-treated boys (n = 267; age: 12.7 ± 2.7 years), 71% of whom had ever taken an SSRI, contributed to the analysis. After adjusting for age, psychostimulant and antipsychotic use, and time in the study, both the duration of SSRI use as well as the cumulative dose were inversely associated with height z score after age 11 years (P < .0001). After adjusting for baseline height, duration of SSRI use was most strongly inversely associated with height z score in Tanner stages 3 and 4 boys who took SSRIs continuously (r = -0.69, P < .009). No association was observed with body mass index z score.
In risperidone-treated boys, SSRI use is associated with reduced longitudinal growth, particularly in those undergoing puberty. Whether adult height or other metabolic or psychological outcomes are affected remains to be determined.
使用利培酮治疗的男孩的便利样本，研究选择性 5-羟色胺再摄取抑制剂 (SSRIs) 是否抑制儿童和青少年的纵向生长，特别是在青春期早期。
对无一般医学条件的 5 至 17 岁接受利培酮治疗的男孩进行的四项基于临床的研究的数据进行了合并，用于此项分析。从医疗和药房记录中提取了人体测量学测量值和精神药物治疗史。线性混合效应回归分析调整了相关混杂因素后，考察了 SSRI 使用与年龄性别特异性身高和体重指数 z 评分变化之间的关系。
接受利培酮治疗的男孩（n=267；年龄：12.7±2.7 岁）中有 71%曾服用过 SSRIs，对分析做出了贡献。在调整了年龄、精神兴奋剂和抗精神病药物的使用以及研究时间后，11 岁以后，SSRIs 使用的持续时间和累积剂量均与身高 z 评分呈负相关（P<0.0001）。在调整了基线身高后，持续使用 SSRIs 的时间与持续使用 SSRIs 的 Tanner 3 期和 4 期男孩的身高 z 评分负相关最强（r=-0.69，P<0.009）。体重指数 z 评分与 SSRIs 使用无相关性。
在利培酮治疗的男孩中，SSRIs 使用与纵向生长减少有关，尤其是在青春期的男孩。是否会影响成年身高或其他代谢或心理结局还有待确定。
