小児重症治療室における妄想症治療のための抗精神病薬:体系的なレビュー
Francesca Cavagnero1, Annalisa Salerno1, Chiara Marchegiani Rizzolli1
1Department of Women's and Children's Health, University Hospital of Padua, Padua, Italy.
Paediatric drugs
|September 4, 2025
まとめ
PICUでの小児性妄想の薬理学的な治療は,QTc延長とディストニアのような異なる有効性と潜在的な安全性に関する懸念を示しています. 証拠に基づいた小児妄想の管理にはさらなる研究が不可欠です.
科学分野:
- 小児集中治療
- 薬理学について
- 体系的検討
背景:
- 小児性妄想 (PD) は小児集中治療室 (PICU) で一般的であり,しばしば診断が不十分である.
- 長期の入院と死亡率の増加を含む有害な結果と関連しています.
- 現在の治療ガイドラインでは,薬物使用に関する証拠が限られているが,非薬理学的方法が優先されている.
研究 の 目的:
- PICUでのPDの薬理学的治療の有効性と安全性を体系的に検討する.
- 常用薬と小児の妄想の管理におけるその有効性を特定する.
- これらの薬理学的介入に関連する有害事象を評価する.
主な方法:
- PRISMAのガイドラインに沿った体系的なレビューが行われました.
- 主要なデータベース (PubMed,Embase,Scopusなど) で検索を行いました. 2024年2月までの研究について
- 対象となった研究は,PICUでPDと診断され,薬物治療を受けている小児患者 (1ヶ月から18歳) に焦点を当てた.
主要な成果:
- 283人の患者を含む10件の遡及研究が分析され,RCTは見つかりませんでした.
- クエチアピン,リスペリドン,ハロペリドールは最も頻繁に使用された薬です.
- オランザピンは1つの研究で症状の有意な改善を示したが,他の研究では傾向を示した. 副作用にはQTc延長とディストニアが含まれていた.
結論:
- PICUでのPDの薬理学的治療は,様々な有効性を示し,一部の患者で有害事象と関連しています.
- 研究の質が低いこと,サンプルサイズが小さいこと,複製の欠如が決定的な結論を妨げています.
- 小児の妄想に対する証拠に基づいた薬理学的戦略を確立するには,さらに高品質な研究が必要である.
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