Hyperprolactinemia-Related Adverse Events Associated with Antipsychotic Treatment in Children and Adolescents
Hyperprolactinemia-Related Adverse Events Associated with Antipsychotic Treatment in Children and Adolescents
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DOI：
10.1016/j.jadohealth.2008.11.010
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发表时间：
2009-07-01
影响因子：
7.6
通讯作者：
Menon, Seema
中科院分区：
文献类型：
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作者：
Jerrell, Jeanette M.;Bacon, Janice;Menon, Seema
目的：旨在描述与接受抗精神病药物和其他精神药物治疗的儿童和青少年发生高催乳素血症和随之而来的生殖/性不良事件相关的因素，以及对合并肥胖、代谢或内分泌疾病的患者造成的额外风险。方法：一项回顾性队列设计，评估南卡罗来纳州医疗补助计划的医疗和药房索赔 用于比较 1998 年 1 月至 2005 年 12 月期间新开具六种非典型药物中的一种或两种常规抗精神病药物的 4140 名儿童和青少年的性/生殖不良事件发生率，以及随机抽取的 4500 名未接受精神药物治疗的儿童样本。进行了 Logistic 和 Cox 比例风险回归和 Kaplan-Meier 生存分析。 与对照样本相比，该队列中出现高催乳素血症相关疾病的可能性并没有显着增加，但女性和 13 岁及以上的青少年却出现了这种情况。女性（比值比 [OR] = 9.52；置信区间 [CI] = 7.63-11.90）、青少年（OR = 3.91；CI = 3.25-4.70）、同时服用选择性血清素再摄取抑制剂 (SSRI)（OR = 2.04；CI = 1.56-2.37）或丙戊酸的人更容易发生生殖/性问题。酸 衍生物（OR = 1.29；CI = 1.03-1.64），以及合并肥胖/体重增加（OR = 1.92；CI = 1.56-2.37）、代谢（OR = 1.41；CI = 1.12-1.78）或内分泌疾病（OR = 2.76；CI = 1.98-3.84）的患者。结论：在本次治疗中队列，女性 接触SSRIs或丙戊酸衍生物的青少年以及服用抗精神病药物时患有肥胖、代谢或内分泌紊乱的青少年发生高催乳素血症和随后发生性/生殖不良事件的风险较高。 (c) 2009 年青少年医学学会。所有紧身衣均保留。
Purpose: To characterize factors related to the development of hyperprolactinemia and the ensuing reproductive/sexual adverse events in children and adolescents treated with antipsychotic and other psychotropic agents, and the additional risk posed for those with comorbid obesity, metabolic, or endocrine disorders.Methods: A retrospective cohort design evaluating medical and pharmacy claims from South Carolina's Medicaid program was used to compare incidence rates for sexual/reproductive adverse events in 4140 children and adolescents who were newly prescribed one of six atypical or two conventional antipsychotic medications, and a random sample of 4500 children not treated with psychotropic medications, January 1998 to December 2005. Logistic and Cox Proportional Hazards regression and Kaplan-Meier survival analysis were performed.Results: The treated cohort was not significantly more likely to evince hyperprolactinemia-related disorders than the control sample, but females and adolescents 13 and older were. Incident reproductive/sexual conditions were more likely for females (odds ratio [OR] = 9.52; confidence interval [CI] = 7.63-11.90), adolescents (OR = 3.91; CI = 3.25-4.70), those also taking selective serotonin reuptake inhibitors (SSRIs) (OR = 2.04; CI = 1.56-2.37) or valproic acid derivatives (OR = 1.29; CI = 1.03-1.64), and those with comorbid obesity/weight gain (OR = 1.92; CI = 1.56-2.37), metabolic (OR = 1.41; CI = 1.12-1.78), or endocrine disorders (OR = 2.76; CI = 1.98-3.84).Conclusion: In this treated cohort, female adolescents exposed to SSRIs or valproic acid derivatives and those with comorbid obesity, metabolic, or endocrine disorders while taking antipsychotics were at higher risk of developing hyperprolactinemia and ensuing sexual/reproductive adverse events. (c) 2009 Society for Adolescent Medicine. All tights reserved.