Vitiello B, Jensen P S
Child and Adolescent Disorders Research Branch, National Institute of Mental Health, Rockville, MD 20857, USA.
Psychopharmacol Bull. 1995;31(1):75-81.
Compared with adults, children and adolescents respond to psychotropic medications in some distinctive ways that have implications for both efficacy and safety. Age-related differences in pharmacokinetics and pharmacodynamics account for some of these differences. But while the disposition of several psychotropics in children has been studied, the pharmacodynamic effects of the interaction between the drug and the developing brain are still largely unknown. There is now evidence that the major neurotransmitter systems undergo developmental changes that can extend into the second decade of life. Data from various animal models also show that the administration of psychotropics in the pre-and perinatal period can interfere with the development and produce permanent changes in the neurotransmitter system in question. The extrapolation of these data to humans is difficult. Given the increase use of psychotropics in the pediatric age, the need emerges for systematic investigation on long-term effects of these drugs on the developing brain.
与成年人相比,儿童和青少年对精神药物的反应有一些独特的方式,这对疗效和安全性都有影响。药代动力学和药效学方面与年龄相关的差异是造成其中一些差异的原因。虽然已经对几种精神药物在儿童体内的处置情况进行了研究,但药物与发育中的大脑之间相互作用的药效学效应在很大程度上仍然未知。现在有证据表明,主要的神经递质系统会经历发育变化,这种变化可持续到生命的第二个十年。来自各种动物模型的数据还表明,在产前和围产期给予精神药物会干扰发育,并在所讨论的神经递质系统中产生永久性变化。将这些数据外推到人类身上很困难。鉴于精神药物在儿科年龄段的使用增加,因此有必要对这些药物对发育中大脑的长期影响进行系统研究。