According to a network gathered analysis published in the "Magazine Magazine in American Children and Youth Psychiatric Society", when treating adolescents with acute irritability or mixed occurrence of bilateral emotional disorders, atypical anti -resistanceThe efficacy of psychiatric drugs is better than traditional mood stabilizers.
The results of the research are unexpected.The previous research by Correll and others found that atypical anti -psychiatric drugs and mood stabilizers have the same curative effect on adults acute or mixed seizures.
Researchers said that these latest results "may be because anti -psychiatric drugs are also due to symptoms related to common diseases, such as confrontation, irritability, emotional and behavioral disorders."However, the use of anti -psychiatric drugs in adolescents must weigh the "worrying" side effects; for example, more sedatives, weight gain, metabolic problems, and high prolactin ledis (higher levels of hormone prolactin levels).
You need to get a balance between efficacy and safety.Ranger is a very acute and serious condition that responds to good drug treatment.However, acute reactions are just beginning, and we need to prevent recurrence.Lithium, as a long -term treatment method, seems to be the safest and most effective for adults, but for children, it is necessary to study more long -term treatment methods because childrens evidence is still scarce.
About half of the two -phase patients will develop before the age of 13. This early -phase bipolar is related to higher suicide risks and more severe chronic diseases.Looking at the treatment and symptoms from a long -term perspective may be more important than comparing the instant effectiveness of a single anticulsion drug.
Research: Deepen
Correll and their colleagues have been incorporated into 18 studies. These studies involve only 18 or 18 years old.Adolescents with mania or mixed manifestation and diagnosed as a two -phase I type.A total of 2,844 teenagers are incorporated, one or more atypical anti -psychiatric drugs (Alilicozole, Asenpin, ozine, sulfurine, ribitone, or Qlazone) or mood stabilizer (Lithium, okasipar, sodium topolin or propyate) compared with other drugs or placebo.Evaluate efficacy, tolerance and security.
All six anti -psychiatric drugs are better than placebo in reducing the symptoms of mania, and except for Zirazone, most drugs have higher treatment reactions than comfort than comfortPrevention.
The main discovery is that the effect of Lipidone in reducing mana symptoms is better thanOther treatment methods, especially for teenagers over 12 years old; but the unfavorable side is, compared with placebo, Lipidone can also lead to a significant increase in prolactin and blood sugar levels.
Among the other anti -psychiatric drugs studied, Qlacicidone is related to metabolic abnormalitiesIt is small, but unfortunately, its curative effect is also low.
In the mood stabilizer, only lithium can cause higher treatment reactions than placebo.
One of the limitations of this outplace analysis is that the average duration of the incorporated research is only five weeks, so the results cannotReveal the mid -term or long -term efficacy of patients.
Consider the overall burden of symptoms
The problem proposed is that which drug is more effective for acute mania, and at the same time, it should be shouldAfter the end of the irritability, patients can continue to take medicine.Some people may improve their condition after taking drugs for treatment of mania, but they cannot tolerate it a month later.
Clinicians should consider the overall burden of patients in various fields and long -term mental symptoms (such as depression, anxiety, or insomnia) when choosing to resist irritation.For example, although anti -psychiatric drugs, although the effect of sulfur flat has a poor effect on irritability, it may be the best choice for patients with high insomnia and anxiety, because it is very beneficial to these symptoms.
Another limitations of the analysis: research involving anti -psychiatric drugs is often greater than the amount of research samples involved in lithium.In view of the differences in statistical ability of different research, these differences may affect the research conclusions.In addition, many of patients taking lithium have given up treatment.For example, hair loss and acne caused by lithium can make adolescents particularly disturbed and cause drug interruption, but they are actually harmless.
Researchers believe that when treating the acute manifestations of children and adults, non -typical anti -psychiatric drugs are more effective and faster than lithium.Although lithium can also effectively treat acute mania, its curative effect is usually small, and the treatment of young people will be delayed, which takes about six to seven weeks.
On the other hand, in view of the fact that young people are prone to increased weight after taking atypical anti -psychiatric drugs, for those patients who have not had acute symptoms at first, they will use it from the beginning.Lithium or let them use lithium to make sense, because lithium can provide long -term benefits without having the same metabolic impact.
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References
Vita G, Nöhles VB, et al. Systematic Review and Network Meta-Analysis: Effical and Safety of AN tipsychotics vsAntiePileptics or Lithium for Acute Mania in Children and Adolescents. j.jaac.2024.07.920.
