期刊
JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY
卷 50, 期 8, 页码 749-762出版社
ELSEVIER SCIENCE BV
DOI: 10.1016/j.jaac.2011.05.011
关键词
pediatric bipolar disorder; psychopharmacology; mania; depression; attention-deficit/hyperactivity disorder
资金
- Pediatric Psychopharmacology Council
- Bantam Books
- National Institute of Mental Health (NIMH), McNeil, Shire
- Eli Lilly and Co.
- Pfizer
- Shire
- National Institutes of Health (NIH)
- Janssen
- McNeil
- Novartis
- Guilford Press
- Elmindo
- Next Wave Pharmaceuticals
- MGH Psychiatry Academy
- AstraZeneca
- Abbott
- Alza
- Bristol Myers Squibb
- Celltech
- Cephalon
- Esai
- Forest
- Glaxo
- Gliatech
- Merck
- National Alliance for Research on Schizophrenia and Depression (NARSAD)
- National Institute on Drug Abuse (NIDA)
- New River
- National Institute of Child Health and Human Development (NICHD)
- NIMH
- Noven
- Neurosearch
- Organon
- Otsuka
- Pharmacia
- Prechter Foundation
- The Stanley Foundation
- UCB Pharma
- Wyeth
Objective: A growing body of literature has documented pediatric bipolar disorder to be a severely impairing form of psychopathology. However, concerns remain as to the inadequacy of the extant literature on its pharmacotherapy. Furthermore, treatment studies have not been systematically reviewed for treatment effects on core and associated symptoms. Thus, a systematic evaluation and synthesis of the available literature on the efficacy of antimanic pharmacotherapy for pediatric bipolar disorder on symptoms of mania, depression, and attention-deficit/hyperactivity disorder was undertaken. Method: A systematic search was conducted through Pub Med from 1989 through 2010 for open-label and randomized controlled trials published in English on the pharmacotherapy of pediatric mania. Results: There have been 46 open-label (n = 29) and randomized (n = 17) clinical trials of antimanic agents in pediatric bipolar disorder encompassing 2,666 subjects that evaluated a range of therapeutic agents, including traditional mood stabilizers, other anticonvulsants, second-generation antipsychotics, and naturopathic compounds. This literature has documented that the available armamentarium has different levels of efficacy in the treatment of pediatric mania. Because all psychotropic classes are associated with important adverse effects, a careful risk-benefit analysis is warranted when initiating pharmacologic treatment with any of these compounds. In the limited data available, the effects of antimanic agents on depression and symptoms of attention-deficit/hyperactivity disorder have been, in general, modest. Few studies have evaluated the effects of antimanic agents in children younger than 10 years. Conclusions: A substantial body of scientific literature has evaluated the safety and efficacy of various medicines and drug classes in the treatment of mania in pediatric bipolar disorder. More work is needed to assess the safety and efficacy of psychotropic drugs in children younger than 10 years, to further evaluate the efficacy of naturopathic compounds, and to further evaluate the effects of antimanic treatments for the management of depression and attention-deficit/hyperactivity disorder. J. Am. Acad. Child Adolesc. Psychiatry, 2011;50(8):749-762.
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