Department of Child and Adolescent Psychiatry, National Center for Mental Health, Seoul, Korea.
Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Korean Med Sci. 2020 Jul 20;35(28):e226. doi: 10.3346/jkms.2020.35.e226.
This study's aim was to investigate whether the incidence of neutropenia was higher in subjects who received a combination pharmacotherapy with valproate (VPA), antipsychotics (APs), and attention deficit hyperactivity disorder (ADHD) medication than in those administered only VPA and APs combination pharmacotherapy. We conducted this study through retrospective review of medical records. We collected the records of 231 children admitted to the National Center for Mental Health. The incidence of neutropenia was significantly higher in the VPA-APs-ADHD combination group than in the other groups (55.2% vs. 25% vs. 12%, VPA + AP + ADHD vs. VPA + AP vs. AP). The presence of the combination of VPA, APs, and ADHD medication was a powerful predictor of neutropenia occurrence after adjusting for age, gender, and body mass index (odds ratio, 6.43; 95% confidence interval, 2.26-18.26; < 0.001) The combination of VPA, APs, and ADHD medication in children with psychiatric disease appears to increase the incidence of drug-induced neutropenia.
本研究旨在探讨与仅接受丙戊酸（VPA）和抗精神病药（APs）联合药物治疗的患者相比，同时接受 VPA、APs 和注意缺陷多动障碍（ADHD）药物联合药物治疗的患者中性粒细胞减少症的发生率是否更高。我们通过回顾性病历审查进行了这项研究。我们收集了国家心理健康中心 231 名儿童的记录。中性粒细胞减少症在 VPA-APs-ADHD 联合组中的发生率明显高于其他组（55.2% vs. 25% vs. 12%，VPA+AP+ADHD vs. VPA+AP vs. AP）。在调整年龄、性别和体重指数后，VPA、APs 和 ADHD 药物联合存在是中性粒细胞减少症发生的有力预测因素（比值比，6.43；95%置信区间，2.26-18.26；<0.001）。儿科疾病患者中 VPA、APs 和 ADHD 药物的联合使用似乎会增加药物引起的中性粒细胞减少症的发生率。
