Morrow Kyle, Young Keith A, Spencer Shawn, Medina Edgar Samuel, Marziale Michaela A, Sanchez Alejandro, Bourgeois James A
Department of Psychiatry, Baylor Scott & White Health, Central Texas Division, and College of Medicine, Texas A&M University Health Science Center, Temple, Texas.
Proc (Bayl Univ Med Cent). 2020 Oct 6;34(1):34-39. doi: 10.1080/08998280.2020.1826259.
The primary aims of this study were to determine if oxcarbazepine is a safely tolerated option for treatment of psychiatric symptoms in children and whether its use facilitates dose modification of other psychotropic medications. A retrospective chart review was completed using data extracted from the electronic medical record of a large outpatient child psychiatry clinic. A total of 507 of 740 children prescribed oxcarbazepine for psychiatric indications for 3 months or more had adequate data to assess clinical responses and medication outcomes. Most patients prescribed oxcarbazepine experienced clinically significant control of irritability/anger, mood stabilization, aggressive outbursts, impulsivity, or anxiety, with over 80% achieving at least maintenance symptom control. In all, 51% and 25% fully discontinued second- or third-generation antipsychotic or antidepressant medication, respectively, after starting oxcarbazepine; 8% discontinued oxcarbazepine for nonresponse, while 9% stopped oxcarbazepine because of emergent side effects. In patients fully discontinuing or reducing the second- or third-generation antipsychotic dose by 50% or more, improvements in body mass index were observed. Oxcarbazepine may prove to be an appropriate alternative to antipsychotic and antidepressant medications for treating psychiatric symptoms in children and adolescents. In particular, it may be a more metabolically neutral psychotropic medication.
本研究的主要目的是确定奥卡西平是否是治疗儿童精神症状的安全耐受选择，以及其使用是否有助于调整其他精神药物的剂量。我们通过回顾一家大型儿童精神科门诊电子病历中的数据，完成了一项回顾性图表审查。在740名因精神科适应症服用奥卡西平3个月或更长时间的儿童中，共有507名儿童有足够的数据来评估临床反应和药物治疗结果。大多数服用奥卡西平的患者在临床上对易怒/愤怒、情绪稳定、攻击性行为、冲动或焦虑有显著控制，超过80%的患者至少实现了症状维持控制。总体而言，开始服用奥卡西平后，分别有51%和25%的患者完全停用了第二代或第三代抗精神病药物或抗抑郁药物；8%的患者因无反应而停用奥卡西平，9%的患者因出现副作用而停用奥卡西平。在完全停用或第二代或第三代抗精神病药物剂量减少50%或更多的患者中，观察到体重指数有所改善。奥卡西平可能被证明是治疗儿童和青少年精神症状的抗精神病药物和抗抑郁药物的合适替代品。特别是，它可能是一种代谢影响较小的精神药物。
