锂治疗儿童和青少年神经性厌食症:临床应用、副作用和耐受性。

IF 1 4区 医学 Q4 PSYCHIATRY Rivista di psichiatria Pub Date : 2022-07-01 DOI:10.1708/3855.38385
Jacopo Pruccoli, Simone Rosa, Luca Bergonzini, Antonia Parmeggiani
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引用次数: 1

摘要

目的:目前的指南,由于潜在的毒性和缺乏临床证据,不推荐使用锂治疗神经性厌食症(AN)。关于该药在患有AN的儿童和青少年中的使用、副作用和耐受性的证据很少,这一人群具有特定的临床、代谢和水电解质平衡特征。在这里,我们报告了一系列因AN住院并接受锂治疗的儿童和青少年的病例。方法:报告7例年轻女性AN患者使用锂离子的病例系列。评估了引入的原因、剂量、配方、血浆水平、药物不良反应(ADR)和心电图(EKG)以及血浆葡萄糖、胆固醇、肌酐、尿素、钠和促甲状腺激素(TSH)水平的改变。Re-sults。引入锂的原因包括情绪不稳定、营养计划依从性不足和精神运动性躁动。所有患者的目标症状均有改善。锂从171.4 (+/-56.7)mg/天开始,增加到600.0 (+/-173.2)mg/天。最常见的计划是每天三次。1个月平均血药浓度为0.6 (+/-0.3)mmol/L。一名患者出现多尿、烦渴和口干,另一名患者出现肌酐激酶升高。心电图、葡萄糖、胆固醇、肌酸酐、尿素、钠无明显变化。结论:在这个因AN住院的儿童和青少年样本中,给药锂可以改善损害依从性的精神症状。所有患者在服用锂后,这些症状都得到了改善。2例报告不良反应。这些数据应该在更广泛的人群和对照研究中进行调查。
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Lithium treatment in children and adolescents with anorexia nervosa: clinical use, side effects and tolerability.

Purpose: Current guidelines, due to potential toxicity and lack of clinical evidence, do not recommend the use of lithium in the treatment of Anorexia Nervosa (AN). Scarce evidence is available on the use, side effects, and tolerability of this drug in children and adolescents with AN, a population characterized by specific clinical, metabolic, and hydro-electrolytic balance features. Here we report a case series of children and adolescents hospitalized for AN and treated with lithium.

Methods: Case series reporting the use of lithium in 7 female young patients with AN. Reasons for introduction, dosages, formulation, plas-ma levels, adverse drug reactions (ADR) and modifi-cations of electrocardiogram (EKG) and plasma levels of glucose, cholesterol, creatinine, urea, sodium, and thyroid-stimulating hormone (TSH) were assessed. Re-sults. Reasons for the introduction of lithium included unstable mood, insufficient compliance with nutri-tional programs, and psychomotor agitation. In all of the patients an improvement on target symptoms was observed. Lithium was started at 171.4 (+/-56.7) mg/day, up to 600.0 (+/-173.2) mg/day. The most frequent scheme was three times daily. The mean plasmatic concentration was 0.6 (+/-0.3) mmol/L at one month. One pa-tient experienced polyuria, polydipsia and dry mouth, and another showed increased creatinine kinase. No major modifications of EKG, glucose, cholesterol, cre-atinine, urea, sodium emerged.

Conclusions: In this sample of children and adolescents hospitalized for AN, lithium was administered to improve psychiatric symptoms impairing compliance. All the patients experienced an improvement on these symptoms after being admin-istered lithium. ADR were reported in 2 cases. These data should be investigated in wider populations and controlled studies.

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来源期刊
Rivista di psichiatria
Rivista di psichiatria 医学-精神病学
CiteScore
5.00
自引率
3.70%
发文量
31
审稿时长
6-12 weeks
期刊介绍: Gli interessi della rivista riguardano l’approfondimento delle interazioni tra mente e malattia, la validazione e la discussione dei nuovi strumenti e parametri di classificazione diagnostica, la verifica delle prospettive terapeutiche farmacologiche e non.
期刊最新文献
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