Sanfins Nuno, Andrade Pedro, Azevedo Jacinto
Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
Department of Clinical Neuroscience and Mental Health, 4480-565 Touguinhó, Portugal.
Medicines (Basel). 2025 Jun 23;12(3):15. doi: 10.3390/medicines12030015.
: Oppositional defiant disorder (ODD) and conduct disorder (CD) are important behavior disorders in children and adolescents, often linked with long-term psychosocial problems. Antipsychotics are frequently prescribed to manage severe symptoms and improve behavior, but their efficacy in this population is still unclear and a lot of physicians are remittent in prescribing them. This systematic review aims to assess the effectiveness of antipsychotic treatment in reducing symptoms associated with ODD and CD in children and adolescents. : Studies that investigated how effective antipsychotic treatments are for children and teens diagnosed with oppositional defiant disorder (ODD) and conduct disorder (CD) were reviewed. Only studies that met a few main criteria were included: participants were between 5 and 18 years old with an ODD or CD diagnosis; the treatment could be any type of antipsychotic, whether typical or atypical; the accepted study designs were randomized controlled trials (RCTs), cohort studies, systematic reviews with meta-analysis, or observational studies. The outcomes of interest were reductions in aggressive or defiant behaviors, improvements in social functioning, and the occurrence of any adverse effects from the medications. There was no restriction on the language of publication, and studies published from 2000 to 2024 were considered. Studies that focused only on non-antipsychotic drugs or behavioral therapies, as well as case reports, expert opinions, and non-peer-reviewed articles did not meet the inclusion criteria. : The review consisted of 13 studies. The results suggest that some antipsychotic drugs-especially atypical antipsychotics-can substantially reduce aggressive and defiant behavior in children and adolescents who have oppositional defiant disorder (ODD) or conduct disorder (CD). Common side effects of these medications include weight gain, sedation, and metabolic problems. : Although adverse effects are a concern, the potential of these medications to manage disruptive behaviors should not be overlooked. When used in combination with behavioral therapy and other forms of treatment, antipsychotics can markedly improve the outcomes of these very difficult-to-treat patients. Clinicians who treat these patients need to consider antipsychotics as a serious option. If they do not, they are denying their patients medication that could greatly benefit them.
对立违抗性障碍（ODD）和品行障碍（CD）是儿童和青少年中重要的行为障碍，常与长期的心理社会问题相关联。抗精神病药物经常被用于控制严重症状并改善行为，但它们在这一人群中的疗效仍不明确，许多医生在开此类药物时犹豫不决。本系统评价旨在评估抗精神病药物治疗对减轻儿童和青少年对立违抗性障碍（ODD）和品行障碍（CD）相关症状的有效性。：对研究抗精神病药物治疗被诊断为对立违抗性障碍（ODD）和品行障碍（CD）的儿童和青少年的效果的研究进行了综述。仅纳入符合一些主要标准的研究：参与者年龄在5至18岁之间，患有对立违抗性障碍（ODD）或品行障碍（CD）；治疗可以是任何类型的抗精神病药物，无论是典型的还是非典型的；公认的研究设计为随机对照试验（RCT）、队列研究、荟萃分析的系统评价或观察性研究。感兴趣的结果是攻击或挑衅行为的减少、社会功能的改善以及药物产生的任何不良反应的发生情况。对发表语言没有限制，考虑2000年至2024年发表的研究。仅关注非抗精神病药物或行为疗法的研究，以及病例报告、专家意见和非同行评审的文章不符合纳入标准。：该综述包括13项研究。结果表明，一些抗精神病药物——尤其是非典型抗精神病药物——可以显著减少患有对立违抗性障碍（ODD）或品行障碍（CD）的儿童和青少年的攻击和挑衅行为。这些药物的常见副作用包括体重增加、镇静和代谢问题。：尽管不良反应令人担忧，但这些药物控制破坏性行为的潜力不应被忽视。当与行为疗法和其他形式的治疗联合使用时，抗精神病药物可以显著改善这些极难治疗的患者的治疗效果。治疗这些患者的临床医生需要将抗精神病药物视为一种严肃的选择。如果他们不这样做，他们就是在拒绝给予患者可能使其受益匪浅的药物。
