Effective prophylactic therapy for cyclic vomiting syndrome in children using amitriptyline or cyproheptadine
Effective prophylactic therapy for cyclic vomiting syndrome in children using amitriptyline or cyproheptadine
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DOI：
10.1542/peds.100.6.977
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发表时间：
1997-12-01
期刊：
影响因子：
8
通讯作者：
Weinberg, WA
中科院分区：
文献类型：
--
作者：
Andersen, JM;Sugerman, KS;Weinberg, WA
Objective.评价我们使用抗偏头痛预防药物阿米替林和赛庚啶预防性治疗儿童周期性呕吐综合征（CVS）的经验。通过回顾性病历审查确定了27例患者（16例男性），诊断时年龄范围为2至16岁，符合CVS的诊断标准，并接受阿米替林（22例）或/和赛庚啶（6例）治疗。个体患者数据由主治医生和/或与患者和家属的访谈证实。入组研究组前的最短随访时间为5个月。根据三种治疗结果对患者进行分层：1）完全应答-无发作; 2）部分应答-发作频率降低50%或更多; 3）无应答-发作频率降低小于50%。在22例接受阿米替林治疗的患者中，16例（73%）完全缓解，4例（18%）部分缓解。赛庚啶治疗的6例患者中，4例（66%）完全缓解，1例（17%）部分缓解。因此，91%的阿米替林组和83%的赛庚啶组对治疗至少有部分反应。两种药物均无明显副作用。抗偏头痛的预防药物，阿米替林和赛庚啶，代表了有效的预防剂的CVS在绝大多数患者的管理符合诊断标准，这种综合征。
Objective. To evaluate our experience using the antimigraine prophylactic drugs, amitriptyline and cyproheptadine, for the prophylactic management of cyclic vomiting syndrome (CVS) in children.Methods and Patients. Twenty-seven patients (16 males) ranging in age from 2 to 16 years at diagnosis, fulfilling the diagnostic criteria for CVS and treated prophylactically with either amitriptyline (22) or/and cyproheptadine (6) were identified through retrospective chart review. Individual patient data were corroborated by the attending physician and/or interviews with patients and families. Minimum follow-up time before entry into the study group was 5 months. Patients were stratified according to three treatment outcomes: 1) complete response-no attacks, 2) partial response-50% or greater reduction in frequency of attacks, and 3) no response-less than 50% decrease in frequency of attacks.Results. Of the 22 patients treated with amitriptyline, 16 (73%) had a complete response while 4 (18%) had a partial response. Of the 6 patients treated with cyproheptadine, 4 (66%) had a complete response and 1 (17%) had a partial response. Thus, 91% of the amitriptyline group and 83% of the cyproheptadine group had at least a partial response to therapy. No patients experienced significant side effects to either medication.Conclusion. The antimigraine prophylactic drugs, amitriptyline and cyproheptadine, represent effective prophylactic agents for the management of CVS in the vast majority of patients fulfilling the diagnostic criteria for this syndrome.