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首页> 外文期刊>Neuropsychiatric Disease and Treatment >Olanzapine approved for the acute treatment of schizophrenia or manic/mixed episodes associated with bipolar I disorder in adolescent patients
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Olanzapine approved for the acute treatment of schizophrenia or manic/mixed episodes associated with bipolar I disorder in adolescent patients

机译：奥氮平被批准用于青少年患者的精神分裂症或躁狂/躁狂发作与双相性I型障碍相关的急性治疗

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Background: Severe and persistent mental illnesses in children and adolescents, such as early-onset schizophrenia spectrum (EOSS) disorders and pediatric bipolar disorder (pedBP), are increasingly recognized. Few treatments have demonstrated efficacy in rigorous clinical trials. Enduring response to current medications appears limited. Recently, olanzapine was approved for the treatment of adolescents with schizophrenia or acute manic/mixed episodes in pedBP.Methods: PubMed searches were conducted for olanzapine combined with pharmacology, schizophrenia, or bipolar disorder. Searches related to schizophrenia and bipolar disorder were limited to children and adolescents. The bibliographies of the retrieved articles were hand-checked for additional relevant studies. The epidemiology, phenomenology, and treatment of EOSS and pedBP, and olanzapine’s pharmacology are reviewed. Studies of olanzapine treatment in youth with EOSS and pedBP are examined.Results: Olanzapine is efficacious for EOSS and pedBP. However, olanzapine is not more efficacious than risperidone, molindone, or haloperidol in EOSS and is less efficacious than clozapine in treatment-resistant EOSS. No comparative trials have been done in pedBP. Olanzapine is associated with weight gain, dyslipidemia, and transaminase elevations in youth. Extrapyramidal symptoms, neuroleptic malignant syndrome, and blood dyscrasias have also been reported but appear rare.Conclusions: The authors conclude that olanzapine should be considered a second-line agent in EOSS and pedBP due to its risks for significant weight gain and lipid dysregulation. Awareness of the consistent weight and metabolic changes observed in olanzapine-treated youth focused attention on the potential long-term risks of atypical antipsychotics in youth.
机译：背景：儿童和青少年的严重和持续性精神疾病，例如早发性精神分裂症谱图（EOSS）疾病和小儿双相情感障碍（pedBP），已得到越来越多的认识。在严格的临床试验中，很少有疗法能显示出疗效。对当前药物的持久反应似乎有限。最近，奥氮平被批准用于治疗儿童精神分裂症或pedBP中的急性躁狂/混合发作的青少年。方法：PubMed搜索奥氮平与药理，精神分裂症或双相情感障碍相结合。与精神分裂症和双相情感障碍有关的搜索仅限于儿童和青少年。手工检查检索到的文章的书目，以进行其他相关研究。对EOSS和pedBP的流行病学，现象学和治疗方法以及奥氮平的药理学进行了综述。结果表明：奥氮平对EOSS和pedBP有效。但是，在EOSS中，奥氮平的疗效不如利培酮，莫林酮或氟哌啶醇，在耐治疗性EOSS中的疗效不如氯氮平。 pedBP尚无比较试验。奥氮平与青年人的体重增加，血脂异常和转氨酶升高有关。锥体外系症状，抗精神病药物恶性综合症和血液异型症也有报道，但很少见。结论：作者认为奥氮平应被认为是EOSS和pedBP的二线药物，因为它具有明显增加体重和脂质失调的风险。在奥氮平治疗的青年中观察到体重和代谢变化的一致性，使人们将注意力集中在青年中非典型抗精神病药的潜在长期风险上。

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