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首页> 外文期刊>Journal of child and adolescent psychopharmacology >Improved Metabolic and Psychiatric Outcomes with Discontinuation of Atypical Antipsychotics in Youth Hospitalized in a State Psychiatric Facility
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Improved Metabolic and Psychiatric Outcomes with Discontinuation of Atypical Antipsychotics in Youth Hospitalized in a State Psychiatric Facility

机译：改善了在国家精神科设施住院中的青年时期非典型抗精神病药的代谢和精神病患者

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Objectives: To assess the impact of antipsychotic tapering and discontinuation on measures of metabolic functioning and psychiatric symptom severity in severely impaired youth hospitalized in a psychiatric state hospital. Methods: The study examined psychiatric and metabolic measures in 67 hospitalized children and adolescents (mean age 11.9; 56 with discontinued use of antipsychotics, 10 with continued use of antipsychotics, and 1 started on an antipsychotic) from admission to discharge. Results: Upon admission, 56 youth were tapered off of antipsychotic medications, started on other forms of pharmacotherapy (92.9% were started on medications used to treat attention-deficit/hyperactivity disorder), and received evidence-based behavioral programming and were ultimately discharged from the hospital. The mean duration of treatment was 228 days for the discontinuation group and 204 days for the continuation group. Significant decreases in body mass index [BMI; t(53)=7.12, p=0.0001] and BMI percentile [t(53)=6.73, p=0.0001] were found from admission to discharge in the antipsychotic discontinuation group. Changes in BMI, BMI percentile, or systolic blood pressure were not found in the group (n=10) who were maintained on antipsychotics. Both groups experienced a significant increase in their Global Assessment of Functioning score [t(52)=19.98, p=0.0001 for discontinued; t(8)=5.092, p=0.001 for maintained]. Psychiatric symptom severity scores significantly improved in many subscales relevant to disruptive behaviors and mood disorders for those who were removed from the medications. For those maintained on the antipsychotics, there were fewer changes in psychiatric symptom scores. Conclusion: Discontinuation of atypical antipsychotic medications in conjunction with tailoring treatment to presenting diagnoses resulted in metabolic and psychiatric symptom improvement among severely impaired state hospital inpatient youth. These results serve as a feasibility demonstration that discontinuation of antipsychotics does not provoke psychiatric destabilization, particularly among disruptive behavior disordered youth.
机译：目标：评估抗精神病药分歧和停止对代谢功能和精神症状严重程度的影响，在精神病院医院住院严重受损的青年中的代谢功能和精神症状严重程度。方法：该研究检测了67名住院儿童和青少年的精神审查和代谢措施（平均年龄11.9; 56，随着抗精神病药的使用，持续使用抗精神病药物，1开始抗精神病药）从入院解释。结果：在入学时，56青年逐渐减少抗精神病药，在其他形式的药物治疗开始（92.9％开始用于治疗注意力缺陷/多动障碍的药物），并获得基于证据的行为规划，最终从医院。停药组的平均治疗持续时间为228天，延续组204天。体重指数的显着降低[BMI;抗抗精神分离失算酶排出组中发现T（53）= 7.12，p = 0.0001]和BMI百分比[T（53）= 6.73，p = 0.0001]。在维持抗精神病药的组（n = 10）中未发现BMI，BMI百分比或收缩压的变化。两组在其全球运作得分评估中经历了显着增加[T（52）= 19.98，P = 0.0001，用于停止; T（8）= 5.092，P = 0.001维护]。对于那些从药物中除去的人，精神病症状严重程度分数显着改善了与破坏性行为和情绪障碍有关的许多分量。对于那些维持抗精神病药的人，精神病症状评分的变化较少。结论：结合剪裁治疗鉴定诊断的鉴定治疗中断了非典型抗精神病药，导致了严重受损的状态医院住院青年中代谢和精神症状改善。这些结果作为可行性示范，即停止抗精神病药物不会引起精神稳定化，特别是在破坏性行为失调的青年时期。

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