Andregenerasjons antipsykotika for atferdsproblemer hos barn: Systematisk oversikt

Second-Generation Antipsychotics for the Treatment of Disruptive Behaviour Disorders in Children: A Systematic Review

Forfattere
Pringsheim, T. Gorman, D.
Årstall
2012
Tidsskrift
Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie
Volum
57
Sider
722-727
Objective: The use of second-generation antipsychotics (SGAs) in youth has increased considerably. Increases are mainly attributable to treatment of disruptive behaviour disorders (DBDs). Our objective was to review the evidence regarding the efficacy of SGAs for DBDs in youth. Method: We performed a systematic review of all randomized controlled trials (RCTs) of SGAs and placebo for the treatment of DBDs in youth, focusing on efficacy data. Results: Eight RCTs in youth with DBDs were included. Five RCTs evaluated the use of risperidone in youth with the combination of subaverage borderline IQ and disruptive behaviour aggression. Single RCTs evaluated the use of risperidone for treatment-resistant aggression in attention-deficit hyperactivity disorder and for the treatment of conduct disorder (CD), and a single ROT evaluated the use of quetiapine for adolescent CD. The efficacy results of each of these studies are described. Conclusion: Four placebo-controlled studies support the short-term efficacy of low-dose risperidone in youth with a subaverage IQ. Placebo-controlled evidence is weak or nonexistent for SGAs other than risperidone, and is weak in youth with an average IQ. Multiple factors likely account for the disconnect between this limited evidence base and the frequent use of SGAs for DBDs in clinical practice. These include extrapolation from studies in youth with autism or a subaverage IQ to normally developing youth; ease of SGA titration and the mistaken perception that little monitoring is required; unavailability of psychosocial treatments; limited familiarity with other pharmacological options; clinical and cultural norms; and the influence of the pharmaceutical industry.

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Tiltaksnivå

Behandling og hjelpetiltak

Tema

Psykiske vansker og lidelser

Atferdsproblemer

Atferdsforstyrrelser

Tiltak

Medikamentell behandling

Antipsykotisk medisin

Aldersgruppe

Barn i skolealder (6-12 år)

Ungdom (13-18 år)

Uklar aldersgruppe

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