Treatment recommendations for the use of antipsychotics for aggressive youth (TRAAY). Part I: a review.
Treatment recommendations for the use of antipsychotics for aggressive youth (TRAAY). Part I: a review.
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针对攻击性青少年使用抗精神病药物的治疗建议（TRAAY）。
DOI：
10.1097/00004583-200302000-00007
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发表时间：
2003
影响因子：
13.3
通讯作者：
Jensen,PeterS
中科院分区：
文献类型：
--
作者：
Schur,SarahB;Sikich,Lin;Findling,RobertL;Malone,RichardP;Crismon,MLynn;Derivan,Albert;MacintyreIi,JamesC;Pappadopulos,Elizabeth;Greenhill,Laurence;Schooler,Nina;VanOrden,Kimberly;Jensen,PeterS
目的回顾非药物和药物治疗儿童和青少年攻击行为的安全性和有效性的证据。方法Medline 和 PsycINFO 检索（1990 年至今）针对非典型抗精神病药物治疗攻击行为的双盲、安慰剂对照研究以及有关使用其他药物和心理社会干预措施治疗攻击行为的文献。在缺乏青少年对照数据的情况下，使用了有关非典型抗精神病药物安全性的病例报告和成人文献。结果 关于青少年攻击行为治疗的对照数据很少。心理社会干预可能单独有效，也可能与药物治疗结合有效。精神药物（例如兴奋剂、情绪稳定剂、β-受体阻滞剂）也被证明在减少攻击性方面效果有限。抗精神病药，特别是非典型抗精神病药，在治疗特定儿科人群的攻击行为方面显示出显着疗效。与典型抗精神病药物相比，非典型抗精神病药物通常与较少的锥体外系症状相关。 结论 心理社会干预和非典型抗精神病药物是治疗青少年攻击行为的有希望的治疗方法。双盲研究应检查非典型抗精神病药物之间以及与其他类别药物相比的安全性和有效性、特定药物对不同攻击亚型的疗效、结合各种精神药物、最佳剂量和长期安全性。
OBJECTIVESTo review the evidence for the safety and efficacy of nonpharmacological and pharmacological treatments for aggression in children and adolescents.METHODMedline and PsycINFO searches (1990–present) were conducted for double-blind, placebo-controlled studies of atypical antipsychotics for aggression and for literature on the use of other pharmacological agents and psychosocial interventions for aggression. Case reports and adult literature regarding the safety of atypical antipsychotics were used where controlled data for youth were lacking.RESULTSControlled data on the treatment of aggression in youth is scarce. Psychosocial interventions may be effective alone or in combination with pharmacological treatments. Psychotropic agents (e.g., stimulants, mood stabilizers, β-blockers) have also been shown to have limited efficacy in reducing aggression. Antipsychotics, particularly the atypical antipsychotics, show substantial efficacy in the treatment of aggression in selected pediatric populations. Atypical antipsychotics are generally associated with fewer extrapyramidal symptoms than are typical antipsychotics.CONCLUSIONSPsychosocial interventions and atypical antipsychotics are promising treatments for aggression in youth. Double-blind studies should examine the safety and efficacy of atypical antipsychotics compared to each other and to medications from other classes, the efficacy of specific medications for different subtypes of aggression, combining various psychotropic medications, optimal dosages, and long-term safety.