"Ukusetyenziswa kweziyobisi kwabantwana abaninzi", kunye ne-antipsychotics, kufuna ukongamela okwandisiweyo

Uphononongo olutsha lubangele ukuxhalaba malunga nezigidi zabantwana base-US-abangaphantsi kwesihlanu-kunye nabakwishumi elivisayo abasebenzisa i-antipsychotics, i-antidepressants, kunye ne-stimulants, ngaphandle kweengozi, kuquka isifo seswekile kunye nokufa.

Ngu-CCHR International
Imboniselo yempilo yengqondo
Septemba 27, 2021

Uphononongo olutsha olugxile kwi-polypharmacy kubantwana abasaqala ukuya esikolweni lutyhila ukuba abantwana abangaphantsi kweminyaka emithandathu emiselweyo ye-antipsychotics banokuphela benikwa amachiza amane okanye ngaphezulu e-psychotropic ngexesha phakathi kweminyaka emihlanu. Abantwana abakhuliswa ngabanye abantwana ngabona basemngciphekweni, benikwa amayeza atshintsha ingqondo ixesha elide kunabanye abantwana. Uphononongo olupapashwe kwi Iinkonzo Zengqondo uphonononge amayeza e-antipsychotic kubantwana besikolo abafumana imivuzo ephantsi, abamelwe eKentucky.[1] Umlindi wecandelo lezempilo yengqondo, iKomishoni yabemi yaMalungelo oLuntu yaMazwe ngaMazwe (CCHR) ilandelele into eyibiza ngokuba “kukusebenzisa iziyobisi kwabantwana abaninzi” e-US, ngakumbi Unyango lwengqondo, nto leyo enokukhokelela kwisifo seswekile nasekufeni yaye ifuna ukongamela ngakumbi.

Ukufumana I-IQVia iyonke iDatha yeNkcazelo yeSigulana ye-2020, I-CCHR ibika ukuba i-829,372 yabo baneminyaka eyi-17 nangaphantsi babekwi-antipsychotics, apho i-30,632 yayineminyaka yobudala ukuya kwiminyaka emihlanu ubudala. Ngokusekelwe kwisifundo saseKentucky kunye nokusebenzisa i-IQ Via, abantwana abaqikelelwayo be-20,421 banokubeka ingozi ye-polypharmacy kwiminyaka eyi-10. Kuzwelonke, izikhuthazi zimiselwe kwi-3.15 yezigidi ze-0-17 ubudala, apho i-58,091 ineminyaka eyi-0. -5 kunye ne-2.15 yezigidi zithatha i-antidepressants, kunye ne-35,216 eneminyaka eyi-0-5.[2]

The Iinkonzo Zengqondo Uphononongo lwafumanisa ukuba ingqalelo-intsilelo hyperactivity disorder (ADHD) imele i-91% yoxilongo olumiselwe i-psychotropics, nangona i-antipsychotics ingavunywanga ukunyanga i-ADHD kubantwana abancinci. Ukuxhalaba kunye noxilongo olunxulumene nonxunguphalo lubalelwa kwi-64% yoxilongo kunye nokuphazamiseka kwe-autism spectrum, i-43%. Ukuba sesichengeni kumachiza kwakuphakathi kwe-avareji ye-1.7 kunye ne-2.6 yeminyaka, kodwa i-27% yamiselwa oku ngaphezu kweminyaka emine.[3]

I-CCHR ithi iimpawu ze-ADHD zixhomekeke kakhulu kangangokuba nawuphi na umntwana unokufunyanwa kakubi. Iimpawu ziquka ukucofa-cofa iminwe, ukuphakuzela, kunye nokuziphatha okungekho emsebenzini, "ukusebenza ngokugqithiseleyo" okanye "ukungxama," ukungahoywa kutitshala, njl njl. Alukho uvavanyo lwebhayoloji lokuqinisekisa i-ADHD. Abona bantwana bancinane kwigumbi lokufundela bafikelela kuma-50% amathuba okuba bafunyanwe kwaye banikwe amayeza kunomdala.

Uphando olupapashwe kwi Inethiwekhi yeJAMA ngoSeptemba ka-2021 kuphononongwe izifundo ezipapashiweyo ezingama-334 ebantwaneni nakulutsha lwaqaphela ukuba abantwana abancinci bafunyanwa ngenxa “yokungakhuli” kwabo.[4]

Ukusebenzisa idatha evela kumabango eKentucky Medicaid ukusuka kwi-2012 ukuya kwi-2017, uphando olupapashwe Iinkonzo Zengqondo kufunyenwe i-31% yabantwana be-316 abaqaliswe kwi-antipsychotic ngo-2012 (abangaphantsi kweminyaka emithandathu) baphelile, kwiminyaka emihlanu ezayo, bamiselwe iiklasi ezine okanye ngaphezulu kweziyobisi. Ukongeza, ama-65% eqela lokuqala lika-2012 laphela limiselwe ubuncinci amachiza amathathu kule minyaka mihlanu ilandelayo. Abo banoluphazamiseko okanye kukhathalelo lomntwana bagqibe ekubeni bathathe amachiza ixesha elide kunabanye abantwana.

Umphandi uNjingalwazi W. David Lohr ovela kwiYunivesithi yaseLouisville uxelele Iindaba zeSpectrum, “Ndinexhala lokuba asibuqondi kakuhle ubungozi obubangelwa ngala mayeza.” Zinxulunyaniswa neziphumo ebezingalindelekanga ezifana nokufumana ubunzima, ukwanda komngcipheko weengxaki ze-metabolic, kunye nokuphazamiseka kwentshukumo. Ii-Antipsychotics zihlala zisetyenziswa ngaphandle kweleyibhile ukunyanga ukuziphatha okuphazamisayo. "Sikwafumene kwiqela lethu ukuba abantwana abaninzi abafumani zifundo zelebhu eziyimfuneko ukujonga i-glucose kunye ne-lipids [amafutha, i-oyile, njl.njl.] amanqanaba ekuphenduleni la mayeza." UGqr. Lohr ufuna ukubona iinkqubo ezicwangcisiweyo, zothintelo.[5]

Abantwana kunye nolutsha olumiselweyo lwe-antipsychotics banomngcipheko owongeziweyo wohlobo lwe-2 yeswekile enokonyuka ngedosi eyongezelelweyo.[6]

I-CCHR ikholelwa ukuba iikhemikhali ezinamandla, eziguqula ingqondo kufuneka zingabandakanywa ngokupheleleyo ekusetyenzisweni kwabantwana.

I-Risperidone iphezulu kuluhlu lwe-antipsychotics kwi-93% ilandelwa Aripiprazole kwi-32%; i-amphetamine-based ezikhuthazayo zimiselwe kwi-72% yamatyala, apho i-methylphenidate imelwe i-61%. Ukuxhatshazwa zimiselwe kwi-63% yamatyala.[7]

I-Risperidone iye yaziwa ngokubangela ukukhula kwebele lendoda, ebizwa ngokuba yi-gynecomastia kumakhwenkwe amancinci; ezinye zezigulane ezichaphazelekayo zide zibe zincinci ezine.[8]

Ngokweziphumo zophononongo ezixelwe kwi-Arhente yoPhando lwezeMpilo kunye noMgangatho (AHRQ), ukwanda kokusetyenziswa kwee-antipsychotics ezingaqhelekanga kudlula ubungqina besayensi nobezonyango obuxhasa ukhuseleko nokusebenza kwazo. Ukusukela ngo-2015, inye kuphela i-antipsychotic evunyiweyo ukuba isetyenziswe phantsi kweminyaka emihlanu ngenxa yokucaphuka okuhambelana noluphazamiseko. Le kunye nenye i-antipsychotic ivunyiwe ukunyanga abo baneminyaka emithandathu ukuya kwesithoba.[9]

Ucwaningo lwe-2019 olupapashwe kwi JAMA Psychiatry ikwagxininise iinkxalabo kuluntu lwezonyango malunga ne-antipsychotics. Uphononongo lokuqwalasela lujonge idatha yabantwana abaphantse babe ngama-248,000 kunye nabantu abadala abaselula eTennessee ukusuka kwiminyaka eyi-5 ukuya kwi-24 ababhalise kwi-Medicaid phakathi kwe-1999 kunye ne-2014. ukufa okungalindelekanga kuneqela lolawulo. Wayne A. Ray, Ph.D., umbhali okhokelayo kunye noprofesa womgaqo-nkqubo wezempilo kwi-Vanderbilt University School of Medicine e-Tennessee, wathi "Iziphumo zibonisa ukuba inkxalabo yokufa okuhlobene ne-antipsychotics kubantu abancinci kunempembelelo ebalulekileyo kwimpilo yoluntu. ” Ukwathe iindlela ezizezinye ziyafuneka.[10]

I-CCHR isebenze kunye namaqela abazali ukukhusela abantwana ekunyanzelweni ukuba bathathe amachiza e-psychotropic njengento efunekayo kwimfundo yabo. Abanye abazali batyholwa ngolwaphulo-mthetho xa bakhupha umntwana wabo—phantsi kwesiluleko sikagqirha—kwiyeza lengqondo. Oku kwakhokelela ekubeni i-CCHR ifumane isilungiso somanyano soKhuseleko lwaMayeza aBantwana ngo-2004 esithintela izikolo ukuba zinyanzelise abantwana besikolo kumachiza engqondo ukuba bahlale esikolweni. I-CCHR ibhale uninzi, ukubhubha kwabantwana okubuhlungu ngenxa yonyango olunyanzelweyo lwengqondo.

I-CCHR ifuna ukubona ulawulo olungqongqo ngakumbi kunyango lwengqondo yabantwana, nothintelo lwalo naluphi na unyanzeliso lwengqondo olusetyenziswa ebantwaneni kunye nokuphendula ngokwenzakala kwabo okanye ukusweleka ngenxa yeziyobisi zengqondo okanye unyango lwe-electroshock. Abazali kufuneka xela naluphi na uxhatshazo kwiCCR.

Eli qela laseka kwakhona a FightForKids iwebhusayithi enikezela ngokuthe ngqo ulwazi lomzali.

Iingxelo:

[1] U-Niko McCarty, "I-Q & A kunye no-W. David Lohr: I-Antipsychotics, i-polypharmacy phakathi kwabafundi be-autistic preschoolers," Iindaba zeSpectrum, 21 Septemba 2021, https://www.spectrumnews.org/opinion/qa-with-w-david-lohr-antipsychotics-polypharmacy-among-autistic-preschoolers/

[2] https://www.cchrint.org/psychiatric-drugs/children-on-psychiatric-drugs/

[3] W. David Lohr, okqhubekayo., "Amayeza e-Antipsychotic kuBantwana abaNgenengeniso ePhantsi: Ixesha elide kunye ne-Psychotropic Medication Polypharmacy," Iinkonzo Zengqondo, 2 Septemba 2021, https://ps.psychiatryonline.org/doi/10.1176/appi.ps.202000673

[4] Evelyn Lewin, "Uphando lufumanisa ukuba i-ADHD ixilongwa ngokugqithiseleyo, kodwa iingcali zihlala zingaqinisekanga," Ijenali yemihla ngemihla yezoNyango, 22 Septemba 2021, https://medicaldailyjournal.com/2021/09/22/research-finds-adhd-is-overdiagnosed-but-experts-remain-unconvinced/

[5] Op. cit., Iindaba zeSpectrum, 21 Septemba 2021

[6] Samaras K, Correll CU, okqhubekayo., "Ingozi yesifo seswekile enokuthi ijongelwe phantsi kulutsha kunye nabantwana abafumana i-antipsychotics," JAMA Psychiatry. 2014 Feb;71(2):209-10. doi: 10.1001/jamapsychiatry.2013.4030, https://pubmed.ncbi.nlm.nih.gov/23965896/

[7] Op. cit., Iindaba zeSpectrum, 21 Septemba 2021

[8] https://www.dolmanlaw.com/risperdal-dangerous-side-effects/

[9] "Amayeza e-Antipical Antipsychotic: Ukusetyenziswa kwiZigulana zaBantwana," amaZiko eMedicare kunye neeNkonzo zeMedicaid (CMS) iMedicaid Integrity Group (MIG), iSebe lezeMpilo kunye neeNkonzo zoLuntu, ngo-Oct 2015, https://www.cms.gov/Medicare -Medicaid-Coordination/Fraud-Prevention/Medicaid-Integrity-Education/Pharmacy-Education-Materials/Downloads/atyp-antipsych-pediatric-factsheet11-14.pdf

[10] UBrian Mastroianni, "Abantwana banokubandezeleka ngenxa yeziphumo ezibi kakhulu ezivela kumayeza e-Antipsychotic," LwezeMpilo, 9 Jan. 2019, https://www.healthline.com/health-news/antipsychotic-meds-may-be-deadly-for-some-children