Clicca qui per scaricare

Condividi
Psicofarmaci in età adolescenziale
Titolo Rivista: RIVISTA SPERIMENTALE DI FRENIATRIA 
Autori/Curatori: Antonio Clavenna, Laura Reale, Daniele Piovani, Maurizio Bonarti 
Anno di pubblicazione:  2016 Fascicolo: 2 Lingua: Italiano 
Numero pagine:  23 P. 79-101 Dimensione file:  244 KB
DOI:  10.3280/RSF2016-002006
Il DOI è il codice a barre della proprietà intellettuale: per saperne di più:  clicca qui   qui 


Nonostante studi internazionali abbiano evidenziato un aumento dell’uso di psicofarmaci in età pediatrica, in Italia la prevalenza di prescrizione è inferiore e stabile nel tempo. Ad oggi mancano ancora studi adeguati per documentare l’efficacia e la sicurezza degli psicofarmaci nella popolazione pediatrica, soprattutto a lungo termine, dal momento che gli studi disponibili hanno breve durata. Il trattamento dei disturbi psichiatrici in età evolutiva richiede un approccio multimodale e multidisciplinare, in cui raramente la terapia farmacologica costituisce il primo approccio terapeutico. La sindrome da iperattività e deficit di attenzione (ADHD) è il disturbo psichiatrico per cui esistono maggiori evidenze a supporto dell’efficacia dei farmaci. I disturbi di tipo endocrino-metabolici (frequenti con gli antipsicotici), il rischio di suicidalità (di possibile comparsa con antidepressivi e atomoxetina) e i rischio di abuso/uso inappropriato sono i più rilevanti effetti indesiderati da monitorare nell’adolescente in trattamento con psicofarmaci.


Keywords: Adolescenti, psicofarmaci, efficacia, sicurezza, revisione

  1. [1] Bachmann CJ, Aagaard L, Burcu M, Glaeske G, Kalverdijk LJ, Petersen I, et al. Trends and patterns of antidepressant use in children and adolescents from five western countries, 2005-2012. European Neuropsychopharmacology 2016; 26: 411-419.
  2. [2] Hartz I, Skurtveit S, Steffenak AK, Karlstad O, Handal M. Psychotropic drug use among 0-17 year olds during 2004-2014: a nationwide prescription database study. BMC Psychiatry 2016; 16: 12.
  3. [3] Steinhausen HC, Bisgaard C. Nationwide time trends in dispensed prescriptions of psychotropic medication for children and adolescents in denmark. Acta Psychiatrica Scandinavica 2014; 129: 221-231.
  4. [4] Weinstein SJ, House SA, Chang CH, Wasserman JR, Goodman DC, Morden NE. Small geographic area variations in prescription drug use. Pediatrics 2014; 134: 563-570.
  5. [5] Zoega H, Baldursson G, Hrafnkelsson B, Almarsdottir AB, Valdimarsdottir U, Halldorsson M. Psychotropic drug use among Icelandic children: a nationwide population-based study. Journal of Child and Adolescent Psychopharmacology 2009; 19: 757-764.
  6. [6] Piovani D, Clavenna A, Cartabia M, Bonati M. Psychotropic medicine prescriptions in Italian youths: a multiregional study. European Child and Adolescent Psychiatry 2016; 25: 235-245.
  7. [7] Le Noury J, Nardo JM, Healy D, Jureidini J, Raven M, Tufanaru C, Abi-Jaoude E. Restoring Study 329: efficacy and harms of paroxetine and imipramine in treatment of major depression in adolescence. BMJ 2015; 351:h4320.
  8. [8] Clavenna A, Andretta M, Pilati P, Dusi M, Gangemi M, Gattoni MB, et al. Antidepressant and antipsychotic use in an Italian pediatric population. BMC Pediatrics 2011; 11: 40.
  9. [9] Ivarsson T, Skarphedinsson G, Kornor H, Axelsdottir B, Biedilae S, Heyman I et al. The place of and evidence for serotonin reuptake inhibitors (SRIs) for obsessive compulsive disorder (OCD) in children and adolescents: Views based on a systematic review and meta-analysis. Psychiatry Research 2015; 227: 93-103.
  10. [10] Hazell P, Mirzaie M. Tricyclic drugs for depression in children and adolescents. Cochrane Database Systematic Review 2013; 6: CD002317.
  11. [11] Hetrick SE, McKenzie JE, Cox GR, Simmons MB, Merry SN. Newer generation antidepressants for depressive disorders in children and adolescents. Cochrane Database Systematic Review 2012; 11: CD004851.
  12. [12] Cipriani A, Zhou X, Del Giovane C, Hetrick SE, Qin B, Whittington C, et al. Comparative efficacy and tolerability of antidepressants for major depressive disorder in children and adolescents: a network meta-analysis. The Lancet 2016; published online June 8 http://, 10.1016/S0140-6736(16)30385-313]StrawnJR,WelgeJA,WehryAM,KeeshinB,RynnMA.Efficacyandtolerabilityofantidepressantsinpediatricanxietydisorders:asystematicreviewandmeta-analysis.DepressionandAnxiety2015;32:149-157DOI: 10.1016/S0140-6736(16)30385-313]StrawnJR,WelgeJA,WehryAM,KeeshinB,RynnMA.Efficacyandtolerabilityofantidepressantsinpediatricanxietydisorders:asystematicreviewandmeta-analysis.DepressionandAnxiety2015;32:149-157
  13. [14] Zuddas A, Zanni R, Usala T. Second generation antipsychotics (SGAs) for nonpsychotic disorders in children and adolescents: a review of the randomized controlled studies. European Neuropsychopharmacology 2011; 21: 600-620.
  14. [15] Stafford MR, Mayo-Wilson E, Loucas CE, James A, Hollis C, Birchwood M, et al. Efficacy and safety of pharmacological and psychological interventions for the treatment of psychosis and schizophrenia in children, adolescents and young adults: a systematic review and meta-analysis. PLoS One 2015; 10: e0117166.
  15. [16] Caccia S, Clavenna A, Bonati M. Antipsychotic drug toxicology in children. Expert Opinion on Drug Metabolism & Toxicology 2011; 7: 591-608.
  16. [17] Chan E, Fogler JM, Hammerness PG. Treatment of attention-deficit/hyperactivity disorder in adolescents: a systematic review. The Journal of the American Medical Association 2016; 315: 1997-2008.
  17. [18] Simeon JG, Ferguson HB, Knott V, Roberts N, Gauthier B, Dubois C, et al. Clinical, cognitive, and neurophysiological effects of alprazolam in children and adolescents with overanxious and avoidant disorders. Journal of the American Academy of Child and Adolescent Psychiatry 1992; 31: 29-33.
  18. [19] Armour A, Gottschlich MM, Khoury J, Warden GD, Kagan RJ. A randomized, controlled prospective trial of zolpidem and haloperidol for use as sleeping agents in pediatric burn patients. Journal of Burn Care & Research 2008; 29: 238-247.
  19. [20] Blumer JL, Findling RL, Shih WJ, Soubrane C, Reed MD. Controlled clinical trial of zolpidem for the treatment of insomnia associated with attentiondeficit/hyperactivity disorder in children 6 to 17 years of age. Pediatrics 2009; 123: e770-e776.
  20. [21] Bonati M. Psicofarmaci nell’età evolutiva. Roma: Il Pensiero Scientifico Editore; 2015.
  21. [22] Zemrak WR, Kenna GA. Association of antipsychotic and antidepressant drugs with Q-T interval prolongation. American Journal of Health-System Pharmacy 2008; 65: 1029-1038.
  22. [23] Hammad TA, Laughren T, Racoosin J. Suicidality in pediatric patients treated with antidepressant drugs. Archives of General Psychiatry 2006; 63: 332-339.
  23. [24] Stone M, Laughren T, Jones ML, Levenson M, Holland PC, Hughes A, et al. Risk of suicidality in clinical trials of antidepressants in adults: analysis of proprietary data submitted to US Food and Drug Administration. British Medical Journal 2009; 339: b2880.
  24. [25] Jerrell JM. Neuroendocrine-related adverse events associated with antidepressant treatment in children and adolescents. CNS Neuroscienze & Therapeutics 2010; 16: 83-90.
  25. [26] Fraguas D, Correll CU, Merchan-Naranjo J, Rapado-Castro M, Parellada M, Moreno C, et al. Efficacy and safety of second-generation antipsychotics in children and adolescents with psychotic and bipolar spectrum disorders: comprehensive review of prospective head-to-head and placebo-controlled comparisons. European Neuropsychopharmacology 2011; 21: 621-645.
  26. [27] De Hert M, Dobbelaere M, Sheridan EM, Cohen D, Correll CU. Metabolic and endocrine adverse effects of second-generation antipsychotics in children and adolescents: A systematic review of randomized, placebo controlled trials and guidelines for clinical practice. European Psychiatry 2011; 26: 144-158.
  27. [28] Galling B, Roldan A, Nielsen RE, Nielsen J, Gerhard T, Carbon M, et al. Type 2 diabetes mellitus in youth exposed to antipsychotics: a systematic review and meta-analysis. JAMA Psychiatry 2016; 73: 247-259.
  28. [29] Clavenna A, Bonati M. Safety and tolerability of medications for adhd. In: Spina E, Trifirò G, ed. Pharmacovigilance in Psychiatry. ADIS; 2016. 233-253.
  29. [30] Stein MA, Weiss M, Hlavaty L. ADHD treatments, sleep, and sleep problems: complex associations. Neurotherapeutics 2012; 9: 509-517.
  30. [31] Graham J, Banaschewski T, Buitelaar J, Coghill D, Danckaerts M, Dittmann RW, et al. European guidelines on managing adverse effects of medication for adhd. European Child and Adolescent Psychiatry 2011; 20: 17-37.
  31. [32] Gould MS, Walsh BT, Munfakh JL, Kleinman M, Duan N, Olfson M, et al. Sudden death and use of stimulant medications in youths. American Journal of Psychiatry 2009; 166: 992-1001.
  32. [33] Hammerness PG, Karampahtsis C, Babalola R, Alexander ME. Attentiondeficit/hyperactivity disorder treatment: what are the long-term cardiovascular risks? Expert Opinion on Drug Safety 2015; 1-9.
  33. [34] Shin J-Y, Roughead EE, Park B-J, Pratt NL. Cardiovascular safety of methylphenidate among children and young people with attention-deficit/hyperactivity disorder (ADHD): nationwide self controlled case study. BMJ 2016; 353:i2550.
  34. [35] Bangs ME, Tauscher-Wisniewski S, Polzer J, Zhang S, Acharya N, Desaiah D, et al. Meta-analysis of suicide-related behavior events in patients treated with atomoxetine. Journal of the American Academy of Child and Adolescent Psychiatry 2008; 47: 209-218.
  35. [36] Bangs ME, Wietecha LA, Wang S, Buchanan AS, Kelsey DK. Meta-analysis of suicide-related behavior or ideation in child, adolescent, and adult patients treated with atomoxetine. Journal of Child and Adolescent Psychopharmacology 2014; 24: 426-434.
  36. [37] Mosholder AD, Gelperin K, Hammad TA, Phelan K, Johann-Liang R. Hallucinations and other psychotic symptoms associated with the use of attention-deficit/hyperactivity disorder drugs in children. Pediatrics 2009; 123: 611-616.
  37. [38] Humphreys KL, Eng T, Lee SS. Stimulant medication and substance use outcomes: a meta-analysis. JAMA Psychiatry 2013; 70: 740-749.
  38. [39] Wilens TE, Gignac M, Swezey A, Monuteaux MC, Biederman J. Characteristics of adolescents and young adults with adhd who divert or misuse their prescribed medications. Journal of the American Academy of Child and Adolescent Psychiatry 2006; 45: 408-414.
  39. [40] Lader M. Benzodiazepine harm: how can it be reduced? Br J Clin Pharmacol. 2014 Feb;77(2):295-301
  40. [41] Brett J, Murnion B. Management of benzodiazepine misuse and dependence. Aust Prescr. 2015;38(5):152-5

Antonio Clavenna, Laura Reale, Daniele Piovani, Maurizio Bonarti, in "RIVISTA SPERIMENTALE DI FRENIATRIA" 2/2016, pp. 79-101, DOI:10.3280/RSF2016-002006

   

FrancoAngeli è membro della Publishers International Linking Association associazione indipendente e no profit per facilitare l'accesso degli studiosi ai contenuti digitali nelle pubblicazioni professionali e scientifiche