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首页> 外文期刊>The journal of clinical psychiatry >Treatment of behavior disorders in mental retardation: report on transitioning to atypical antipsychotics, with an emphasis on risperidone.
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Treatment of behavior disorders in mental retardation: report on transitioning to atypical antipsychotics, with an emphasis on risperidone.

机译：智力低下的行为障碍的治疗：报告过渡到非典型抗精神病药，重点是利培酮。

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BACKGROUND: Mental illnesses are more common in people with mental retardation and developmental disabilities than in the general population. Due to the difficulty of making specific psychiatric diagnoses in these patients, the target of medication is often a behavioral symptom. For many symptoms, antipsychotic medications are effective, but the serious side effect profile of conventional antipsychotics renders their use problematic. Recent findings concerning the safety and efficacy of atypical antipsychotics for control of certain disruptive behaviors in adults and children led a Special Topic Advisory Panel to draw up guidelines for transitioning patients with specific symptoms from classical antipsychotics to risperidone and, by extrapolation, to other atypical agents. PARTICIPANTS: Participants were chosen by Janssen Pharmaceutica, based on individual achievements and lifetime experience. The Special Topic Advisory Panel on Transitioning to Risperidone Therapy in Patients With Mental Retardation and Developmental Disabilities comprised academic clinicians with at least 10 years' experience in the field of mental retardation and developmental disabilities. It included a clinical pharmacist, consultant pharmacists, a certified developmental disabilities nurse, psychiatrists, a family physician, and a psychologist. EVIDENCE: The Panel considered recent studies of the efficacy and tolerability of risperidone and other atypical antipsychotics in adults and children with mental retardation and developmental disabilities. MEDLINE searches were conducted using the name of each atypical antipsychotic and the following terms: mental retardation, developmental disabilities, and behavior disorders. Searches were conducted starting in July 2002 and done periodically through April 2004 to capture new additions to the literature. Searches were confined to English. GUIDELINES PROCESS: The Panel reviewed the available evidence, identified optimal doses and titration schedules, considered instruments and rating scalesfor assessing symptoms, and developed guidelines. CONCLUSIONS: The guidelines set forth initial and target doses and titration schedules of risperidone therapy for some behavioral symptoms and provide recommendations concerning withdrawal of previous medications and for procedures and rating scales for assessing symptoms. In patients with severe retardation, the goal is often to identify specific target behaviors rather than to pursue an exact diagnosis, which may be unattainable.
机译：背景：精神疾病在智力低下和发育障碍的人群中比在普通人群中更为普遍。由于在这些患者中难以做出具体的精神病诊断，因此药物治疗的目标通常是行为症状。对于许多症状，抗精神病药是有效的，但是常规抗精神病药的严重副作用使它们的使用成问题。有关非典型抗精神病药控制成人和儿童某些破坏性行为的安全性和有效性的最新发现，导致特殊主题咨询小组起草了将具有特定症状的患者从经典抗精神病药转变为利培酮，并通过外推法过渡到其他非典型药物的指南。 。参与者：Janssen Pharmaceutica根据个人成就和一生的经验选择了参与者。智力迟钝和发育障碍患者向利培酮治疗过渡的专题咨询小组由在智力障碍和发育障碍领域至少有10年经验的学术临床医生组成。它包括一名临床药剂师，顾问药剂师，一名认证的发育残疾护士，精神科医生，家庭医生和心理学家。证据：专家小组审议了有关利培酮和其他非典型抗精神病药在患有智力障碍和发育障碍的成人和儿童中的功效和耐受性的最新研究。使用每种非典型抗精神病药的名称和以下术语进行MEDLINE搜索：智力低下，发育障碍和行为障碍。搜索从2002年7月开始，直到2004年4月定期进行，以获取新的文献资料。搜索仅限于英语。准则程序：专家小组审查了现有证据，确定了最佳剂量和滴定时间表，考虑了用于评估症状的工具和等级量表，并制定了准则。结论：该指南为某些行为症状列出了利培酮治疗的初始剂量和目标剂量以及滴定时间表，并提供了有关停药的建议以及评估症状的程序和等级量表。在严重智障患者中，目标通常是确定特定的目标行为，而不是进行准确的诊断，而这可能是无法实现的。

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