Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte, Brazil.
J Child Adolesc Psychopharmacol. 2024 Nov;34(9):e419-e426. doi: 10.1089/cap.2024.0070. Epub 2024 Sep 30.
It is essential not to delay behavior management and control for aggression, violence, and impulsive behavior in young people. Clozapine has been widely used in adolescents and adults to manage violence and aggression in Schizophrenia. However, there are limited data on the use of clozapine in children, and no systematic review has addressed its use in this population. To better understand the conditions under which clozapine is used as a therapeutic alternative for nonschizophrenic diagnoses and to assess the current evidence supporting its prescription to children, a systematic review was conducted. The review followed PRISMA guidelines and was registered in PROSPERO under the ID CRD42024537707. The review identified that all the studies used clozapine to address externalizing behavior, particularly aggressive behavior, and found positive outcomes supporting its use for treating children with treatment-resistant aggression. The studies also found that clozapine was well-tolerated in all cases. However, the studies were limited and mainly consisted of open trials without a control group. Further high-quality research is needed to establish precise guidelines for using clozapine in children.
对于青少年的攻击、暴力和冲动行为，必须及时进行行为管理和控制。氯氮平已广泛用于青少年和成人，以控制精神分裂症的暴力和攻击行为。然而，氯氮平在儿童中的使用数据有限，也没有系统评价专门探讨其在该人群中的应用。为了更好地了解氯氮平作为非精神分裂症诊断的治疗替代药物的使用条件，并评估支持将其用于儿童的现有证据，进行了一项系统评价。该评价遵循 PRISMA 指南，并在 PROSPERO 中以 ID CRD42024537707 进行了注册。该评价确定，所有研究均使用氯氮平来解决外化行为，特别是攻击行为，并发现了支持其用于治疗治疗抵抗性攻击的儿童的积极结果。研究还发现，氯氮平在所有情况下均具有良好的耐受性。然而，这些研究存在局限性，主要是没有对照组的开放试验。需要进一步开展高质量的研究，以制定在儿童中使用氯氮平的精确指南。
