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首页> 外文期刊>Translational Developmental Psychiatry >Atypical antipsychotic prescribing patterns amongst Child and Adolescent Mental Health Services clinicians in a defined National Health Service Trust
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Atypical antipsychotic prescribing patterns amongst Child and Adolescent Mental Health Services clinicians in a defined National Health Service Trust

机译：明确的国家卫生服务基金会（National Health Service Trust）中的儿童和青少年心理健康服务临床医生中的非典型抗精神病药处方模式

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BackgroundIn the last decade, the prescription of atypical antipsychotics in minors, by all specialists, has increased. The use has been both licensed and ‘off-label’, with the aim of targeting different symptoms and clinical conditions. However, most research around safety and efficacy of these pharmacological agents has been conducted in adults and with repeated calls for such research in minors in vain.ObjectivesThis survey aims to describe current prescribing practices in a ‘real-world’ scenario and to compare the results with existing research to evaluate lessons learnt.MethodsThe survey consisted of a semi-structured questionnaire that aimed to evaluate the current practices of Child and Adolescent Mental Health Services (CAMHS) prescribers. A total of 31 questionnaires sent out yielded 24 completed returns (77.41%). A literature search yielded articles that described prescribing trends over the last decade. The results from the survey were compared with the existing literature.ResultsThe commonest indication for using atypical antipsychotics in minors was psychosis (75%). Other indications included reduced behavioural control (50%), tic disorders (37.5%), ADHD and anxiety disorders. Atypical antipsychotics were the commonest first-line medications for managing behavioural control with Risperidone (54%) being the most preferred agent. Second-line medications included Quetiapine (7%) and Olanzapine (15%). Doses were lower for managing behavioural control, and atypical antipsychotics were trialled for up to 8 weeks, and with duration of treatment extending up to 9 months. When such medications were used for non-psychotic presentations, most common target symptoms were aggression (85%), agitation (54%) and anxiety (54%). Most prescribers reported peer/expert opinion and their own clinical experience as evidence base for their use and clinical practice.ConclusionsIn the investigated sample, atypical antipsychotics continue to be used as first-line medications for psychotic and non-psychotic psychiatric presentations in minors, despite an absence of clear evidence comparable to the adult literature, and also despite repeated calls for in-depth research in this particular population. Although the present survey was conducted amongst psychiatrists, this has implications for all prescribers in children and adolescents, regardless of their specialty.
机译：背景技术在过去的十年中，所有专家对未成年人进行非典型抗精神病药的处方有所增加。该用途已获许可且“不在标签上”，目的是针对不同的症状和临床状况。然而，关于这些药理学药物安全性和功效的大多数研究都是在成年人身上进行的，并且反复呼吁在未成年人中进行此类研究是徒劳的。目的本次调查旨在描述现实世界中当前的处方实践并比较结果方法该调查包括一个半结构化问卷，旨在评估儿童和青少年心理健康服务（CAMHS）处方者的当前行为。总共发出31份问卷，完成了24份回报（占77.41％）。文献搜索得出的文章描述了过去十年的处方趋势。将调查结果与现有文献进行比较。结果未成年人中使用非典型抗精神病药的最常见指征是精神病（75％）。其他适应症包括行为控制降低（50％），抽动障碍（37.5％），注意力缺陷多动障碍和焦虑症。非典型抗精神病药是用于管理行为控制的最常见的一线药物，其中利培酮（54％）是最优选的药物。二线药物包括Quetiapine（7％）和Olanzapine（15％）。用于控制行为控制的剂量较低，并且对非典型抗精神病药进行了长达8周的试验，治疗持续时间长达9个月。当此类药物用于非精神病性表现时，最常见的目标症状是攻击性（85％），躁动（54％）和焦虑症（54％）。大多数处方者报告了同行/专家的意见和他们自己的临床经验，作为他们使用和临床实践的证据基础。结论在所调查的样本中，非典型抗精神病药继续被用作未成年人精神病和非精神病性精神病表现的一线药物，尽管尽管没有明确的证据可与成人文献相提并论，并且尽管多次呼吁对该特定人群进行深入研究。尽管本次调查是在精神科医生中进行的，但这对儿童和青少年的所有开处方者都有影响，无论他们的专业如何。

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