BACKGROUND:Second-generation antipsychotics are commonly associated with metabolic complications. These medications are being used more frequently for the treatment of mental health disorders in children, which has stimulated the need for creating formal guidelines on monitoring their safety and effectiveness. Previous guidelines have been developed for monitoring metabolic and neurological complications. To assist practitioners who perform these monitoring procedures, a complementary set of treatment recommendations have been created for situations in which abnormal measurements or results are encountered. OBJECTIVE:To create evidence-based recommendations to assist in managing metabolic complications in children being treated with second-generation antipsychotics. METHODS:A systematic review of the literature on metabolic complications of second-generation antipsychotic medications in children was conducted. Members of the consensus group evaluated the information gathered from the systematic review of the literature and used a nominal group process to reach a consensus on treatment recommendations. Wherever possible, references were made to existing guidelines on the evaluation and treatment of metabolic abnormalities in children. RESULTS:Evidence-based recommendations are presented to assist in managing metabolic complications including weight gain; increased waist circumference; elevation in prolactin, cholesterol, triglyceride and glucose levels; abnormal liver function tests and abnormal thyroid studies. CONCLUSION:The use of second-generation antipsychotics requires proper monitoring procedures. The present treatment guideline provides guidance to clinicians on the clinical management of metabolic complications if they occur.

译文

背景:第二代抗精神病药通常与代谢并发症相关。这些药物被更频繁地用于治疗儿童的精神疾病,这刺激了建立监测其安全性和有效性的正式指南的需求。已经开发了用于监测代谢和神经系统并发症的先前指南。为了帮助执行这些监视程序的从业人员,针对遇到异常测量或结果的情况创建了一套补充的治疗建议。
目的:建立基于证据的建议,以帮助管理接受第二代抗精神病药治疗的儿童的代谢并发症。
方法:对儿童第二代抗精神病药物的代谢并发症的文献进行了系统的综述。共识小组成员评估了从文献系统回顾中收集的信息,并使用名义上的小组程序就治疗建议达成共识。尽可能参考有关儿童代谢异常评估和治疗的现有指南。
结果:提出了循证医学建议,以帮助控制包括体重增加在内的代谢并发症。腰围增加;催乳激素,胆固醇,甘油三酸酯和葡萄糖水平升高;肝功能检查异常和甲状腺检查异常。
结论:使用第二代抗精神病药需要适当的监测程序。本治疗指南为临床医生就代谢并发症(如果发生)的临床管理提供了指导。

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