Weight gain and metabolic effects of mood stabilizers and antipsychotics in pediatric bipolar disorder: A systematic review and pooled analysis of short-term trials
Weight gain and metabolic effects of mood stabilizers and antipsychotics in pediatric bipolar disorder: A systematic review and pooled analysis of short-term trials
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DOI：
10.1097/chi.0b013e318040b25f
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发表时间：
2007-06-01
影响因子：
13.3
通讯作者：
Correll, Christoph U.
中科院分区：
文献类型：
--
作者：
Correll, Christoph U.
目的：综述情绪稳定治疗对儿童双相情感障碍体重和代谢的影响。方法：系统性PubMed/fidedfine检索了至少9例儿童双相情感障碍患者使用情绪稳定药物后体重和/或血糖/血脂值变化的研究。结果：纳入了19项研究，包括24项药物试验，涉及684例患者（平均年龄12.3 ± 2.9岁）。青少年接受锂、抗癫痫药或其组合（n = 459），或第二代抗精神病药，单独或与锂或双丙戊酸钠联合（n = 225），持续4至48周（平均值，15.4 +/- 12.7）。在18项（75.0%）试验中，体重增加显著/具有临床意义。托吡酯组（2项研究，38例受试者）和阿立哌唑组（1项研究，14例受试者）的体重减轻显著。在持续0.05的试验中，科恩的d = 1.34）。在两项第二代抗精神病药物试验中，非空腹血糖/血脂变化无显著性（n = 61，8.9%）。结论：关于儿童双相情感障碍中情绪稳定剂对身体成分影响的数据很少，也缺乏对空腹代谢影响的数据。将抗精神病药物与情绪稳定剂结合使用似乎比使用一种或两种情绪稳定剂治疗更容易导致体重增加。
Objective: To review weight and metabolic effects of mood-stabilizing treatments in pediatric bipolar disorder. Method: Systematic PubMed/fidedfine search of studies reporting on change in weight and/or glucose/lipid values with mood-stabilizing drugs in at least nine pediatric patients with bipolar disorder. Results: Nineteen studies, including 24 medication trials in 684 patients (mean age, 12.3 +/- 2.9 years) were included. Youngsters received lithium, antiepileptics, or their combinations (n = 459), or second-generation antipsychotics, alone or combined with lithium or divalproex (n = 225), for 4 to 48 (mean, 15.4 +/- 12.7) weeks. Weight increase was significant/clinically relevant in 18 (75.0%) trials. Weight loss was significant with topiramate (2 studies, 38 subjects) and present with aripiprazole (1 study, 14 subjects). In trials lasting .05, Cohen's d = 1.34). Nonfasting glucose/lipid changes were nonsignificant in two second-generation antipsychotic trials (n = 61, 8.9%). Conclusions: Data are sparse regarding body composition effects and lacking for fasting metabolic effects of mood stabilizers in pediatric bipolar disorder. Combining antipsychotics with mood stabilizers seems to lead to greater weight gain than treatment with one or two mood stabilizers.