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首页> 外文期刊>Child and adolescent psychiatric clinics of North America >Developmentally Informed Pharmacotherapy for Child and Adolescent Depressive Disorders
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Developmentally Informed Pharmacotherapy for Child and Adolescent Depressive Disorders

机译：儿童和青少年抑郁症的知情药物治疗

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摘要

RCTs have demonstrated the acute efficacy of SSRIs for depression in youth. Evidence from more than one RCT supports the use of fluoxetine in the treatment of childhood and adolescent depression as well as escitalopram in the treatment of adolescent depression. Based on these RCTs, fluoxetine has been given an FDA indication for the treatment of MDD in youth aged 8 years and older whereas escitalopram has been given an FDA indication for the treatment of MDD in adolescents 12 years and older. To date, only one RCT has demonstrated the effectiveness of sertraline or citalopram for the treatment of MDD in youth. Pharmacokinetics studies in youth suggest that dosing strategies of SSRIs may be different for children compared to adolescents, especially for children with low weight. Fluoxetine administration may need to be started at lower doses in children. If withdrawal symptoms are reported with escitalopram, citalopram, or sertraline at once daily dosing, then switching to twice daily should be considered. SSRIs are generally well tolerated by children and adolescents, but careful monitoring for adverse events during the first 2 months of treatment is recommended.
机译：随机对照试验证明了SSRIs对青年抑郁症的急性疗效。来自多个RCT的证据支持氟西汀用于治疗儿童和青少年抑郁症，艾司西酞普兰用于治疗青少年抑郁症。根据这些RCT，氟西汀已被FDA批准用于治疗8岁以上的年轻人的MDD，而依西酞普兰已被FDA批准用于治疗12岁及以上的青少年MDD。迄今为止，只有一项RCT证明了舍曲林或西酞普兰治疗青少年MDD的有效性。青年时期的药代动力学研究表明，与青少年相比，儿童的SSRI给药策略可能有所不同，尤其是体重较轻的儿童。儿童可能需要以较低的剂量开始氟西汀的给药。如果据报道每日服用一次艾司西酞普兰，西酞普兰或舍曲林有戒断症状，​​则应考虑改为每日两次。儿童和青少年通常对SSRI耐受良好，但建议在治疗的前2个月内仔细监测不良事件。

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