ISSN:1044-5463    

DOI:10.1089/cap.2000.10.1

年代:2000

数据来源: MAL

摘要:

ABSTRACTObjective:In anorexia nervosa (AN), medical stabilization and nutritional repletion are pivotal steps toward physical and psychological recovery. Nutritional stabilization is often difficult in this patient group. Recombinant human growth hormone (rhGH) has been safely used as adjuvant therapy in other groups of malnourished patients. We hypothesize that rhGH treatment will hasten medical stabilization in AN patients.Study Design:Fifteen patients admitted for inpatient treatment for AN, ages 12–18 years, were enrolled in a 28-day randomized, double-blind, placebo-controlled study. Patients received rhGH (0.05 mg/kg subcutaneously) or an equivalent volume of placebo daily. Outcome measures included time to reach medical/cardiovascular stability, rate of weight gain, and duration of hospitalization. All patients received a standard refeeding protocol.Results:Mean admission body mass index was 14.5 kg/m2. The rhGH and placebo groups did not differ significantly in admission weight, BMI or daily caloric intake. Patients treated with rhGH reached medical/cardiovascular stability more rapidly than those treated with placebo (median 17 vs. 37 days,p= 0.02). Numerical but not statistically significant improvements were seen in weight gain and length of hospitalization in the rhGH group.Conclusion:Patients treated with rhGH achieved medical/cardiovascular stability more rapidly than those treated with placebo, and this, in turn, decreased the length of sta

ISSN:1044-5463    

DOI:10.1089/cap.2000.10.3

年代:2000

数据来源: MAL

摘要:

ABSTRACTObjective:The aim of the study was to evaluate therapeutic effects and tolerability of fluvoxamine (150–200 mg daily) in 21 dysthymic adolescents.Subjects:Twenty-one adolescents, attending psychiatric clinics, who met DSM-III-R criteria for dysthymia, without significant co-morbidity were the subjects.Methods:Results:Good clinical response (decrease of HAMD-S score>50%) was observed after 4 weeks in 48% of patients; after 8 weeks in 56% of patients, and after 26 weeks in 44% patients. Relapse occurred in 34% of subjects. Fluvoxamine was well tolerated in 76.2% of the adolescents; poor toleration resulted in its discontinuation in 14.2% adolescent

ISSN:1044-5463    

DOI:10.1089/cap.2000.10.9

年代:2000

数据来源: MAL

摘要:

ABSTRACTOpen-label risperidone was administered to 26 subjects (24 boys: 19 with borderline IQ and 5 with mild mental retardation), 10–18 years old, who were hospitalized for treatment of psychiatric disorders associated with aggressive behavior. Risperidone was given in daily doses ranging from 0.5 to 4 mg for periods of 2–12 months. Treatment response was monitored by means of the improvement scale of the CGI and the modified OAS. Extrapyramidal side effects were measured on the ESRS. Fourteen (54%) of 26 subjects had a marked reduction in aggression; 10 subjects had a moderate reduction; two subjects had mild changes; and none worsened. Two subjects had a marked weight gain in the first 8 weeks of treatment. In seven of the 22 children who continued taking risperidone after week 8, tiredness and sedation that necessitated dose reduction emerged between weeks 8 and 16. These results suggest that risperidone may be useful when treating severe aggressive behavior in children and adolescents. Weight gain and sedation can be troublesome side effe

ISSN:1044-5463    

DOI:10.1089/cap.2000.10.19

年代:2000

数据来源: MAL

摘要:

ABSTRACTThe clinical course of a 9-year-old diagnosed with attention-deficit hyperactivity disorder, obsessive-compulsive disorder, and Tourette's disorder and treated with a combination of methylphenidate, clonidine, and fluoxetine is described. The patient experienced over a 10-month period, signs and symptoms suggestive of metabolic toxicity marked by bouts of gastrointestinal distress, low-grade fever, incoordination, and disorientation. Generalized seizures were observed, and the patient lapsed into status epilepticus followed by cardiac arrest and subsequently expired. At autopsy, blood, brain, and other tissue concentrations of fluoxetine and norfluoxetine were several-fold higher than expected based on literature reports for overdose situations. The medical examiner's report indicated death caused by fluoxetine toxicity. As the child's adoptive parents controlled medication access, they were investigated by social welfare agencies. Further genetic testing of autopsy tissue revealed the presence of a gene defect at the cytochrome P450CYP2Dlocus, which results in poor metabolism of fluoxetine. As a result of this and other evidence, the investigation of the adoptive parents was terminated. This is the first report of a fluoxetine-related death in a child with a confirmed genetic polymorphism of theCYP2D6gene that results in impaired drug metabolism. Issues relevant to child and adolescent psychopharmacology arising from this case are discussed.

ISSN:1044-5463    

DOI:10.1089/cap.2000.10.27

年代:2000

数据来源: MAL

摘要:

ABSTRACTThe selective serotonin reuptake inhibitors (SSRIs) are becoming widely used in children and adolescents, with possible unexpected side effects being observed over time. SSRIs have been associated with bleeding in adults who have unremarkable routine hematologic laboratory results except abnormal bleeding time or platelet counts in few cases. Given the increase of pediatric SSRI prescriptions, in this article we describe five children, ages 8 through 15, who developed bruising or epistaxis 1 week to 3 months after starting SSRI treatment. It is possible that the effects SSRI on platelet functioning are causing the bleeding observed in some patients and/or that a separate coagulopathy is present and contributing to bleeding. The subject matter deserves future investigation.

ISSN:1044-5463    

DOI:10.1089/cap.2000.10.35

年代:2000

数据来源: MAL

摘要:

ABSTRACTThe use of methylphenidate (MPH) in combination with antiepileptic drugs is gaining acceptance for children with epilepsy who have the symptoms of attention-deficit hyperactivity disorder (ADHD). We report two cases of an adverse effect of dyskinesia and bruxism when MPH was given to children maintained on valproic acid. These adverse effects were rapid and severe. Because of the potential for serious and persistent side effects from this combination of medications, caution is warranted in the treatment of ADHD with MPH for children taking valproic acid. Further prospective studies of the use of valproic acid and MPH in combination are required.

ISSN:1044-5463    

DOI:10.1089/cap.2000.10.39

年代:2000

数据来源: MAL

摘要:

ABSTRACTWe report on three cases of acutely manic prepubertal children diagnosed with bipolar disorder who were treated with olanzapine in addition to their existing mood stabilizer regimens. All three had marked improvement of their manic symptoms within 3–5 days of beginning olanzapine therapy as measured by clinician-rated instruments. Adverse effects included sedation and weight gain. These results suggest that olanzapine may have an antimanic or mood stabilizing effect in acutely manic children with bipolar disorde

ISSN:1044-5463    

DOI:10.1089/cap.2000.10.45

年代:2000

数据来源: MAL

ISSN:1044-5463    

DOI:10.1089/cap.2000.10.51

年代:2000

数据来源: MAL