2010, Number 1
<< Back Next >>
Bol Med Hosp Infant Mex 2010; 67 (1)
Pharmacoepidemiology of psychotropic drugs used in the service of child Psychiatry of the General Hospital of Durango, México
Lares AI, Sosa MM, Alanis BRE, Sánchez P, Guillé PG, Loera CV, Galaviz HC
Language: Spanish
References: 41
Page: 27-36
PDF size: 165.32 Kb.
ABSTRACT
Background. Psychoactive drugs represent an alternative for the management of mental disorders during infancy and adolescence, which are not exempt from adverse events. We undertook this study to determine the prevalence of psychiatric disorders and their pharmacological management in children and adolescents who attend the Child Psychiatry Service of the
General Hospital of Durango, México.
Methods. Clinical and pharmacological histories of 111 patients from 2 to 17 years of age under treatment for 1 year in the Service of Infantile Psychiatry of the
General Hospital of Durango (SSA) were reviewed.
Results. The most frequent disorder found was attention deficit hyperactivity disorder (ADHD) (23.4%). Monotherapy was used in 23.4% of the patients, whereas in 75.6% of the cases polypharmacy was used. The most common prescribed drugs were antipsychotics, antidepressants and their combinations.
Conclusion. This study emphasizes pharmacoepidemiological knowledge with the purpose of improving efficiency and safety of drug use in an attempt to optimize and individualize treatment with psychoactive drugs in pediatric patients.
REFERENCES
Murray C, Lopez A. Alternative projections of mortality and disability by cause 1999-2020: global burden of disease study. Lancet 1997;349:1498-1504.
Garralda E. Child and adolescent psychiatry in general practice. Aust N Z J Psych 2001;35:308-314.
Molinello H, Campo A. Uso de psicofármacos en niños y adolescentes: indicaciones y manejo. Trib Med 1997;95:345-353.
Olfson M, Marcus SC, Weissman MM, Jensen PS. National trends in the use of psychotropic medications by children. J Am Acad Child Adolesc Psych 2002;41:514-521.
Wong ICK, Camilleri-Novak D, Stephens P. Rise in psychotropic drug prescribing in children in the UK –an urgent public health issue. Drug Safety 2003;26:1117-1118.
Wong ICK, Murray ML, Camilleri-Novak D, Stephens P. Increased prescribing trends of paediatric psychotropic medications. Arch Dis Child 2004;89:1131-1132.
Zito JM, Safer DJ, dosReis S, Gardner JF, Boles M, Lynch F. Trends in the prescribing of psychotropic medications in preschoolers. JAMA 2000;283:1025-1030.
Zito JM, Safer DJ, dosReis S, Gardner JF, Magder L, Soeken K, et al. Psychotropic practice patterns for youth: a 10-year perspective. Arch Pediatr Adolesc Med 2003;157:17-25.
Phillips T, Salmon G, James AC. Prescribing practices in child and adolescent psychiatry: change over time 1993-2000. Child Adolesc Ment Health 2003;8:23-28.
Greenhill LL. The use of psychotropic medication in preschoolers: indications, safety and efficacy. Can J Psych 1998;43:571-575.
Cheng-Shannon J, McGough JJ, Pataki C, McCracken JT. Second-generation antipsychotic medications in children and adolescents. J Child Adolesc Psychopharmacol 2004;14:372-394.
Findling RL, McNamara NK. Atypical antipsychotics in the treatment of children and adolescents: clinical applications. J Clin Psych 2004;65:30-44.
Kowatch RA, DelBello MP. The use of mood stabilizers and atypical antipsychotics in children and adolescents with bipolar disorders. CNS Spectr 2003;8:273-280.
Pappadopulos EA, Tate Guelzow B, Wong C, Ortega M, Jensen PS. A review of the growing evidence base for pediatric psychopharmacology. Child Adolesc Psych Clin N Am 2004;13:817-855.
Correll CU, Carlson HE. Endocrine and metabolic adverse effects of psychotropic medicatios in children and adolescents. J Am Acad Child Adolesc Psych 2006;45:771-791.
McConville BJ, Sorter MT. Treatment challenges and safety considerations for antipsychotic use in children and adolescents with psychoses. J Clin Psych 2004;65: 20-29.
Llerena A. Pharmacogenetics of antidepressant drug metabolism and its clinical imlications. En: Licinio J, editor. Biology of Depression. Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim; 2005.pp.877-900.
Nebert D. Clinical importance of the cytochromes P450. Lancet 2002;12:1155-1162.
Kiivet RA, Llerena A, Dahl ML, Rootslane L, Sanchez Vega J, Eklundh T, et al. Patterns of drug treatment of schizophrenic patients in Estonia, Spain and Sweden. Br J Clin Pharmacol 1995;40:467-476.
Llerena A, Kiivet RA. Fixed combinations of neuroleptics with antidepressants: potential risks and estimation of use. Br J Clin Pharmacol 1994;37:531-532.
Bonati M, Clavenna A. The epidemiology of psychotropic drug use in children and adolescents. Int Rev Psych 2005;17:181-188.
Leslie KL, Weckerly J, Landsverk J, Hough RL, Hurlburt MS, Wood PA. Racial/ethnic differences in high-risk children and adolescents. J Am Acad Child Adolesc Psych 2003;42:1433-1442.
Cooper WO, Hickson GB, Fuchs C, Arbogast PG, Ray WA. New users of antipsychotic medications among children enrolled in TennCare. Arch Pediatr Adolesc Med 2004;158:753-759.
Jensen PS, Bhatara VS, Vitiello B, Hoagwood K, Feil M, Burke LB. Psychoactive medication prescribing practices for U.S. children: Gaps between research and clinical practice. J Am Acad Child Adolesc Psych 1999;38:557-565.
Clark AF. Incidences of new prescribing by British child and adolescent psychiatrists: a prospective study of 12 months. J Psychopharmacol 2004;18:115-120.
Kaplan A. Medication prescribing practices for children and research needs. Psychiatric Times 1999;XVI,Issue 9.
Martin A, Van Hoof T, Stubbe D, Sherwin T, Scahill L. Multiple psychotropic pharmacotherapy among child and adolescent enrollees in Connecticut Medicaid Managed Care. Psychiatr Serv 2003;54:72-77.
Efron D, Hiscock H, Sewell JR, Cranswick NE, Vance AL, Tyl Y, et al. Prescribing of psychotropic medications for children by Australian pediatricians and child psychiatrists. Pediatrics 2003;111:372-375.
Swanson JM, Connor DE, Cantwell D. Combining methylphenidate and clonidine: ill-advised. J Am Acad Child Adolesc Psych 1999;38:617-619.
Grob CS, Coyle JT. Suspected adverse methylphenidate-imipramine interactions in children. J Dev Behay Pediatr 1986;7:265-267.
Cooper TB, Simpson GM. Concomitat imipramine and methylphenidate administration: a case report. Am J Psych 1973;130:721.
Wharton RN, Perel Jm, Dayton PG, Malitz S. A potential clinical use for methylphenidate with tricyclic antidepressants. Am J Psych 1971;127:1619-1625.
Gram LF. Effects of perphenazine on imipramine metabolism in man. Psychopharmacol Commun 1975;1:165-75.
Brosen K. Recent developments in hepatic drug oxidation, implications for clinical pharmacokinetics. Clin Pharmacokinet 1990;18:220-239.
Hall J, Naranjo CA, Sproule BA, Herrmann N. Pharmacokinetic and pharmacodynamic evaluation of the inhibition of alprazolam by citalopram and fluoxetine. J Clin Psychopharmacol 2003;23:349-357.
Greenblatt DJ, Preskorn SH, Cotreau MM, Horst WD, Harmatz JS. Fluoxetine impairs clearance of alprazolam but not of clonazepam. Clin Pharmacol Ther 1992;52:479-486.
Sproule BA, Naranjo CA, Brenmer KE, Hassan PC. Selective serotonin reuptake inhibitors and CNS drug interactions. A critical review of the evidence. Clin Pharmacokinet 1997;33:454-471.
Secretaría de Salud. Programa de Acción: Salud Mental. Diagnóstico Epidemiológico 2001;11:43-57. Disponible en: http://sersame.salud.gob.mx/progaccio_sm.htm. (Consultado: 10-02-2009)
Caraveo AJ, Medina-Mora ME, Villatoro J, López-Lugo EK, Martínez VA. Detección de problemas de salud mental en la infancia. Salud Pública Méx 1995;37: 445-451.
Zarin DA, Suarez AP, Pincus HA, Kupersanin E, Zito JM. Clinical and treatment characteristics of children with attention-deficit/hyperactivity disorder in psychiatric practice. J Am Acad Child Adolesc Psych 1998;37:1262-1270.
Vitiello B, Jensen PS. Mediaction development and testing in children and adolescents. Arch Gen Psych 1997;54:871-876.