Antidepressants and Psychostimulants in Pediatric Populations
Antidepressants and Psychostimulants in Pediatric Populations
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儿童中的抗抑郁药和精神兴奋剂
DOI：
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
K. Chang
中科院分区：
文献类型：
--
作者：
M. Goldsmith;Manpreet K. Singh;K. Chang
本文回顾了有关暴露于精神刺激剂或抗抑郁药是否会缓解或加重躁狂症状，或降低儿童人群中躁狂发作年龄的文献。使用相关关键词的PubMed搜索确定了针对五个不同临床群体的研究：(I)在接触精神刺激剂时没有被诊断为双相情感障碍(BD)的青年；(Ii)在接触精神刺激剂时被诊断为BD的青年；(Iii)在接触抗抑郁药时没有被诊断为BD的青年；(Iv)在接触抗抑郁药物时被诊断为BD的青年；以及(V)在接触这些药物后患上BD的年轻人。在注意力缺陷多动障碍(ADHD)患者中，使用精神刺激剂的躁狂风险相对较低。对于患有BD和ADHD的患者，在添加兴奋剂之前，有效的情绪稳定是重要的。对于患有抑郁和/或焦虑的儿童，抗抑郁剂引起的躁狂(AIM)的风险一般较低(<；2%)，但选择性5-羟色胺再摄取抑制剂(SSRI)继发的一般“激活”风险可能更大(2%-10%)。然而，专科诊所的AIM发生率似乎要高得多。SSRIs在特定人群中可能特别有问题，例如那些有躁狂症状或BD家族史的人，但确切的风险尚不清楚。在总体样本中，没有明确的证据表明兴奋剂或SSRI可以加速BD的自然进程，但在个别情况下，当处方医生在已经有患BD风险的青年中使用这些药物时，例如那些患有ADHD和情绪失调、既往有AIM病史、精神病史或BD家族史的人，应该谨慎行事。
This article reviews the literature that examines whether exposure to psychostimulants or antidepressants precipitates or exacerbates manic symptoms, or decreases the age at onset of mania in pediatric populations. A PubMed search using relevant key words identified studies targeting five distinct clinical groups: (i) youth without a diagnosis of bipolar disorder (BD) at the time of exposure to psychostimulants; (ii) youth with a diagnosis of BD at the time of exposure to psychostimulants; (iii) youth without a diagnosis of BD at the time of exposure to antidepressants; (iv) youth with a diagnosis of BD at the time of exposure to antidepressants; and (v) youth who develop BD after exposure to these medications.In patients with attention-deficit hyperactivity disorder (ADHD), the risk for mania was found to be relatively low with the use of psychostimulants. For patients with BD and ADHD, effective mood stabilization is important prior to adding a stimulant. For children with depression and/or anxiety, the risk of antidepressant-induced mania (AIM) was generally low (<2%), but the risk of general ‘activation’ secondary to a selective serotonin reuptake inhibitor (SSRI) may be greater (2–10%). However, rates of AIM in specialty clinics appear to be much higher. SSRIs may be particularly problematic in specific populations, such as those with some symptoms of mania or a family history of BD, but the precise risk is unknown. There is no clear evidence that stimulants or SSRIs accelerate the natural course of BD development in overall samples, but in individual cases prescribers should proceed cautiously when using these agents in youth already at risk for developing BD, such as those with ADHD and mood dysregulation, a history of prior AIM, a history of psychosis, or a family history of BD.
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DOI：
10.1097/00004583-200401000-00016
发表时间：
2004-01-01
影响因子：
13.3
作者：
Shaffer, D;Scott, M;Greenwald, S
通讯作者：
Greenwald, S
影响因子：
--
作者：
D. Shaffer;M. Gould;James Robert Brašić;P. Ambrosini;P. Fisher;H. Bird;S. Aluwahlia
通讯作者：
D. Shaffer;M. Gould;James Robert Brašić;P. Ambrosini;P. Fisher;H. Bird;S. Aluwahlia
DOI：
10.1097/00004583-200104000-00014
发表时间：
2001-04-01
影响因子：
13.3
作者：
Geller, B;Zimerman, B;Soutullo, C
通讯作者：
Soutullo, C
影响因子：
17.7
作者：
Johnson, JG;Cohen, P;Brook, JS
通讯作者：
Brook, JS
影响因子：
--
作者：
G. Emslie;A. Rush;W. Weinberg;R. Kowatch;C. Hughes;T. Carmody;J. Rintelmann
通讯作者：
G. Emslie;A. Rush;W. Weinberg;R. Kowatch;C. Hughes;T. Carmody;J. Rintelmann