长效注射用（LAI）抗精神病药物联合治疗重度精神病性障碍及伴有攻击行为的青少年：病例系列
Combination long-acting injectable (LAI) antipsychotic medication in adolescents with severe psychosis and aggression: a case series.
作者信息
McInnis Peter, Kasinathan John
机构信息
Consultant Child and Adolescent Psychiatrist, Sydney Local Health District, Sydney, NSW, Australia.
Consultant Forensic, Child and Adolescent Psychiatrist, Adolescent Unit, The Forensic Hospital, Matraville, NSW, and; Conjoint Senior Lecturer, School of Psychiatry, University of New South Wales, Sydney, NSW, Child and Adolescent Mental Health Service, ACT Health, Sydney, NSW, and; Visiting Fellow, Centre for Mental Health Research, Australian National University, Canberra, ACT, and; The Level 8 Practice, Sydney, NSW, Australia.
出版信息
Australas Psychiatry. 2019 Apr;27(2):160-164. doi: 10.1177/1039856218815744. Epub 2018 Nov 26.
OBJECTIVES
We examine the use of combination long-acting injectable (LAI) antipsychotic medication for adolescents with severe psychosis and aggression. We discuss benefits and risks with this approach, for a highly challenging small group of young people.
METHODS
A clinical summary is given of three adolescents admitted to a secure adolescent forensic inpatient unit, and the literature is reviewed.
RESULTS
In these adolescents with severe psychosis, aggression and violent offending, combination LAI antipsychotics effectively treated psychosis and enabled transfer to less restrictive settings. Brief Psychiatric Rating Scale (BPRS) scores decreased significantly with treatment, without any severe adverse effects.
CONCLUSIONS
Combination LAI antipsychotics may be an effective treatment for adolescents with severe psychosis and aggression where clozapine is not a realistic therapeutic option. Close monitoring for side-effects, clear documentation of clinical reasoning and appropriate safeguards are important.
目的
我们研究了联合使用长效注射用（LAI）抗精神病药物治疗患有严重精神病和攻击行为的青少年的情况。我们讨论了这种方法对于一小群极具挑战性的年轻人的益处和风险。
方法
给出了三名入住青少年安全法医住院单元的青少年的临床总结，并对文献进行了综述。
结果
在这些患有严重精神病、攻击行为和暴力犯罪的青少年中，联合使用长效注射用抗精神病药物有效地治疗了精神病，并使他们能够转到限制较少的环境中。治疗后简明精神病评定量表（BPRS）得分显著下降，且无任何严重不良反应。
结论
对于氯氮平不是现实治疗选择的患有严重精神病和攻击行为的青少年，联合使用长效注射用抗精神病药物可能是一种有效的治疗方法。密切监测副作用、清晰记录临床推理过程以及采取适当的保障措施很重要。
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