Tardive Dyskinesia with Antipsychotic Medication in Children and Adolescents: A Systematic Literature Review.

IF 4 2区医学 Q1 PHARMACOLOGY & PHARMACY

Drug Safety Pub Date : 2024-11-01 Epub Date: 2024-06-11 DOI:10.1007/s40264-024-01446-0

Frank M C Besag, Michael J Vasey, Iffah Salim, Chris Hollis

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引用次数: 0

Abstract

Background: Tardive dyskinesia (TD) is a persisting, and potentially irreversible, movement disorder associated with treatment with dopamine receptor antagonists. Few data are available on the risk of TD in children and adolescents treated with antipsychotic medication.

Objective: To review the literature on incidence, risk factors, and treatment options for antipsychotic-associated TD in children and adolescents (aged < 18 years).

Methods: Relevant articles were identified through a systematic search of Embase and Medline performed in January 2024. Methodological quality was assessed using the Newcastle-Ottawa Scale and Joanna Briggs Institute Critical Appraisal tools.

Results: Thirteen studies were identified. The reported TD point prevalence was 5-20%, with higher rates in studies involving typical antipsychotics. Lower estimates (around 1%) emerged from analyses of clinical database data suggesting underdiagnosis in clinical practice. Risk factors included treatment with typical antipsychotics, higher doses, longer duration of exposure, older age, female gender, higher baseline Abnormal Involuntary Movements Scale (AIMS) scores, intellectual impairment, and perinatal complications.

Conclusion: Although relatively few cases have been reported in children and adolescents, TD remains a risk in this population. Individuals receiving antipsychotics should be monitored carefully for the emergence of abnormal movements. Other than dose reduction, discontinuation, or switch to a lower-risk antipsychotic, few interventions have demonstrated efficacy. The strongest evidence for pharmacological treatment is for VMAT-2 inhibitors (valbenazine and deutetrabenazine), but these drugs are not licensed for use in children. To reduce risk, antipsychotics should be prescribed only if necessary, at the minimum effective dose and for the minimum necessary duration.

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儿童和青少年服用抗精神病药物引起的迟发性运动障碍：系统性文献综述。

背景：迟发性运动障碍（TD）是一种与多巴胺受体拮抗剂治疗相关的持续性、可能不可逆的运动障碍。有关接受抗精神病药物治疗的儿童和青少年患 TD 的风险的数据很少：回顾有关儿童和青少年（年龄小于 18 岁）抗精神病药物相关 TD 的发病率、风险因素和治疗方案的文献：方法：于2024年1月对Embase和Medline进行系统检索，确定相关文章。采用纽卡斯尔-渥太华量表（Newcastle-Ottawa Scale）和乔安娜-布里格斯研究所（Joanna Briggs Institute）批判性评估工具对方法学质量进行评估：结果：共发现 13 项研究。报告的 TD 点患病率为 5-20%，涉及典型抗精神病药物的研究中患病率较高。临床数据库数据分析得出的估计值较低（约为1%），表明临床实践中诊断不足。风险因素包括使用典型抗精神病药物治疗、剂量较大、接触时间较长、年龄较大、女性、异常不自主运动量表（AIMS）基线评分较高、智力障碍和围产期并发症：尽管儿童和青少年中的病例报道相对较少，但TD在这一人群中仍然存在风险。接受抗精神病药物治疗的患者应仔细观察是否出现异常运动。除了减少剂量、停药或改用风险较低的抗精神病药物外，很少有干预措施能证明其疗效。最有力的药物治疗证据是VMAT-2抑制剂（戊苯丙肼和去甲戊苯丙肼），但这类药物未获得儿童使用许可。为了降低风险，只有在必要时才应处方抗精神病药物，并且应使用最低有效剂量和持续最短必要时间。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Drug Safety 医学-毒理学

CiteScore

7.60

自引率

7.10%

发文量

112

审稿时长

6-12 weeks

期刊介绍： Drug Safety is the official journal of the International Society of Pharmacovigilance. The journal includes: Overviews of contentious or emerging issues. Comprehensive narrative reviews that provide an authoritative source of information on epidemiology, clinical features, prevention and management of adverse effects of individual drugs and drug classes. In-depth benefit-risk assessment of adverse effect and efficacy data for a drug in a defined therapeutic area. Systematic reviews (with or without meta-analyses) that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. Original research articles reporting the results of well-designed studies in disciplines such as pharmacoepidemiology, pharmacovigilance, pharmacology and toxicology, and pharmacogenomics. Editorials and commentaries on topical issues. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Drug Safety Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.