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  • Küçük Resim
    Öğe
    The prescribing pattern of paliperidone in a pediatric population
    (Taylor & Francis Ltd, 2018) Yektaş, Çiğdem; Paşabeyoğlu, Başak; Mutlu, Caner; Erdoğan, Ayten
    OBJECTIVES: Paliperidone is a relatively new atypical antipsychotic, offers a potential new treatment option for adolescents, with several advantages including single dosage per day and availability in hepatic problems. However, there is a lack of efficacy and safety data for the use of this medication in various psychiatric disorders among children and adolescents. In this study, we retrospectively investigated the use of paliperidone in various psychiatric disorders among a youth population. METHODS: The children and adolescents treated with paliperidone for any psychiatric problem at the outpatient and inpatient Child and Adolescent Psychiatry clinics of Duzce University Medical Faculty Hospital and Bakirkoy Mental Health Hospital were evaluated for the study. Data were collected retrospectively from the patient records. Patients' charts were reviewed to retrieve additional data on indications of the medications, adverse drug reactions (ADRs) and changes in the clinical condition. The clinical status of individual patients was assessed using the Clinical Global Index (CGI) score for severity and improvement. RESULTS: The mean age of patients was 15.8 +/- 1.3 years, and 59.6% (n = 31) of the group was male and 40.4% (n = 21) was female. Paliperidone was prescribed for median 150 days (quartiles 60 and 487 days). The median average daily dose was 7.6 mg/day (range 3-12 mg/day). The main indications for paliperidone prescription were psychotic disorders and bipolar disorders (BPDs) (17 patients, 32.6%; 16 patients, 30.7%, respectively). The other most common diagnostic group was disruptive behavior disorders (DBDs) associated with attention deficit hyperactivity disorder (ADHD), autism spectrum disorders, intellectual disability, conduct disorders, or oppositional defiant disorders (15 patients; 28.8%) tic/neurological disorder (4 patients; 7.9%). Thirty-five patients (67.4%) did not have a diagnosis of schizophrenia and were considered to have received these drugs off-label. Dosing was notably lower in the group of DBDs patients than for patients with BPD or psychotic disorders. Of the 52 patients receiving paliperidone, 53.9% of patients were concurrently treated at some point with one or more than one of a psychostimulant/ADHD medication, an other antipsychotics, an antidepressant, a mood stabilizer, and any other class of psychotropic drug (such as a sleep medication). Totally, ADRs were recorded in 26 (50%) patients: weight gain (n = 24); extra pyramidal symptoms (n = 8); gastrointestinal system symptoms (n = 4); insomnia (n = 2); hyperprolactinemia (n = 4); sedation (n = 2); and skin affection (n = 1). CONCLUSIONS: In this study group, paliperidone has been commonly used for schizophrenia, but it has also been used for mood disorders, DBDs, and Tourette's disorder in children and adolescents. Results showed clinically meaningful improvements in symptom measurements of different disorders. The drug is generally well tolerated and the most frequent adverse events include rigidity, akathisia, sedation, and increased appetite. Future prospective studies with large samples are needed for definite conclusions.
  • Küçük Resim
    Öğe
    Risperidone use in preschool children with aggressive and destructive behavioral symptoms
    (2015) Mutlu, Caner; Şükran, Özden Üneri; Tanıdır, Canan; Güneş, Hatice; Çöpür, Mazlum; Kılıçoğlu, Ali Güven; Erdoğan, Ayten
    Amaç: Temel olarak agresif ve yıkıcı davranışsal belirtiler ile başvuran okul öncesi çağdaki çocuklarda risperidon kullanım yaygınlığı ve özelliklerini araştırmayı amaçladık. Yöntem: Bu geriye dönük dosya tarama çalışmasında, hastaların tıbbi kayıtları yaş, cinsiyet, birincil ve eş tanılar, risperidon dozu ve tedavi süresi açısından gözden geçirildi. Risperidon dozu ve tedavi süresi birincil tanılar arasında karşılaştırıldı. Bulgular: Risperidonun 2790 çocukta kullanım yaygınlığı %18.5ti (s516). Ortalama yaş 4.861.12 yıl idi. Bu hastaların %74.4ünde bir yıkıcı davranış bozukluğu (YDB) birincil tanısı vardı. Risperidon ortalama başlangıç dozu 0.35 mg/gün ve ortalama idame dozu 0.52 mg/gün idi. Tedavinin ortalama süresi 4.9 ay idi. Zeka geriliği (ZG) olan hastalarda, YDB olan hastalara göre, başlangıç ve sürdürme dozları anlamlı olarak daha yüksek ve tedavi süresi anlamlı olarak daha uzundu. Tartışma: Okul öncesi çocuklarda, risperidon MR olan hastalarda daha yüksek dozlarla ve daha uzun süreli tedavi ile azaltılabilen agresif ve yıkıcı davranışsal belirtilerini kontrol etmek için sıklıkla kullanılır Agresif ve yıkıcı davranışları olan çocuklar için kanıta dayalı tedavi yöntemlerinin geliştirilmesi kontrollü çalışmalara ve onların klinik pratiğe uygunluğunun onayını gerektirir.
  • Küçük Resim
    Öğe
    Risperidone use in preschool children with aggressive and destructive behavioral symptoms
    (Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2015) Mutlu, Caner; Üneri, Özden Şükran; Tanıdır, Canan; Güneş, Hatice; Çöpür, Mazlum; Kılıçoğlu, Ali Güven; Erdoğan, Ayten
    Objective: We aimed to investigate the prevalence and mode of risperidone use in preschool aged children admitted with a chief complaint of aggressive and destructive behavioral symptoms. Methods: In this retrospective chart review study, medical records of the patients were reviewed for age, gender, primary and comorbid diagnoses, dosage and duration of risperidone treatment. Dosage and duration of risperidone treatment were compared among primary diagnoses. Results: In 2790 children prevalence of risperidone use was 18.5% (n=516). Mean age was 4.86 +/- 1.12 years. Of these patients, %74.4 had primary diagnosis of a disruptive behavior disorder (DBD). Mean starting dosage of risperidone was 0.35 mg/day and mean maintenance dosage was 0.52 mg/day. The mean length of treatment was 4.9 months. Starting and maintenance doses were significantly higher and treatment duration was longer in patients with mental retardation (MR) than in those with DBDs. Conclusion: In preschoolers, risperidone is frequently used to control aggressive and destructive behavioral symptoms which may improve with higher doses and longer treatment in those with MR. The development of evidence-based treatment modalities for children with aggressive and destructive behaviors necessitates controlled studies and confirmation of their pertinence to clinical practice.