儿童们使用精神科药物的风险跟效益资料.pptVIP

* * * * * * * * * * * * * * * * * * Use of Psychiatric Drugs in Children:  Risks Benefits儿童们使用精神科药物的风险与效益 * Potential Conflict of Interests Professor Tang received sponsorships and supports from E Lilly, GSK, Lundbeck, Astra Seneca, Wyeth, Janssen,Organon. Professor Tang does not own shares/stocks in above companies. Professor Tang is a faculty member of Lundbeck Institute. * Use of Psychiatric Drugs in Children:  Risks Benefits儿童们使用精神科药物的风险与效益 Many more young patients are on psychiatric drugs越来越多青少年病人服用精神科药物 Surge in the use of Antipsychotics in Child and Adolescence Age 1-17 * Pre-natal产前: Before conception 受精前(effects on germ cells)(对生殖细胞的影响). At conception受精 B. At birth (withdrawal e.g. alcohol, heroin, paroxetine) 出生时(脱瘾症状 例如:酒精,海落英,帕罗西汀) Before Puberty (development of neurons, prunning, erroneous cell migration in brain) 青春期前(神经发展及修展,错配的脑细胞迁移) Around Puberty (hormones)青春期(荷尔蒙) Young Adulthood (brain consolidation)成人期 Possible effects of Psychiatric Drugs in Children Adolescence儿童期和靑春期使用精神科药物治疗可能的影响 * Lipophilic: brain is a fatty organ, many psychiatric drugs are highly fat soluble and drugs will stay for long time. 脂溶性: 脑是脂肪酸器官, 许多精神病药物是高脂溶性, 药物会留在体内一段长的时间. 2. Multi-targets: not only going to sites you wanted, but to many other unwanted targets. 多目标: 不仅影响單一的目标, 而且可能影响其他系统. Possible effects of Psychiatric Drugs in Children Adolescence儿童期和靑春期使用精神科药物治疗可能的影响 * 3. Teratogeniety畸形形成 (e.g. 25 mg paroxetine daily):not easy to control. 例如每日服用超过 25毫克帕罗西汀可引至畸形形成现象. Non-teratogeneity effects: other biological results (e.g. infant persistent pulmonary hypertension: 6-12 /1000 babies on paroxetine). 其他非畸形生理影响: (如每1000受母体内帕罗西汀影响的婴儿有6-12个持续性肺动脉高压案例). Possible effects of Psychiatric Drugs in Children Adolescence儿童期和靑春期使用精神科药物治疗可能的影响 * 5. Drug-drug interaction: patient may be taking multiple drugs causing CYP enzymes interaction. Many psychiatric drugs are potent CYP enzyme inhibitors. 药物相互作用:病者同时服同多种药物可能引至不稳