Amerio A, Ossola P, Scagnelli F, Odone A, Allinovi M, Cavalli A, Iacopelli J, Tonna M, Marchesi C, Ghaemi S N
Department of Mental Health, Mental Health Service of Fidenza, Parma, Italy; Mood Disorders Program, Tufts Medical Center, Boston, MA, USA.
Department of Medicine and Surgery, Unit of Neuroscience, University of Parma, Parma, Italy.
Eur Psychiatry. 2018 Oct;54:85-97. doi: 10.1016/j.eurpsy.2018.07.012. Epub 2018 Aug 18.
Many clinicians are reluctant to use traditional mood-stabilizing agents, especially lithium, in children and adolescents. This review examined the evidence for lithium's safety and efficacy in this population.
A systematic review was conducted on the use of lithium in children and adolescents with bipolar disorder (BD). Relevant papers published through June 30 2018 were identified searching the electronic databases MEDLINE, Embase, PsycINFO and the Cochrane Library.
30 articles met inclusion criteria, including 12 randomized controlled trials (RCTs). Findings from RCTs demonstrate efficacy for acute mania in up to 50% of patients, and evidence of long-term maintenance efficacy. Lithium was generally safe, at least in the short term, with most common side effects being gastrointestinal, polyuria, or headache. Only a minority of patients experienced hypothyroidism. No cases of acute kidney injury or chronic kidney disease were reported.
Though the available literature is mostly short-term, there is evidence that lithium monotherapy is reasonably safe and effective in children and adolescents, specifically for acute mania and for prevention of mood episodes.
许多临床医生不愿在儿童和青少年中使用传统的心境稳定剂，尤其是锂盐。本综述探讨了锂盐在该人群中的安全性和有效性证据。
对锂盐用于双相情感障碍（BD）儿童和青少年的情况进行了系统综述。通过检索电子数据库MEDLINE、Embase、PsycINFO和Cochrane图书馆，确定了截至2018年6月30日发表的相关论文。
30篇文章符合纳入标准，其中包括12项随机对照试验（RCT）。RCT的结果表明，高达50%的患者在急性躁狂发作时有疗效，且有长期维持疗效的证据。锂盐总体上是安全的，至少在短期内如此，最常见的副作用是胃肠道反应、多尿或头痛。只有少数患者出现甲状腺功能减退。未报告急性肾损伤或慢性肾病病例。
尽管现有文献大多为短期研究，但有证据表明，锂盐单药治疗在儿童和青少年中是相当安全有效的，特别是对于急性躁狂发作和预防情绪发作。
