Subject(s)
Antipsychotic Agents/adverse effects , Electrocardiography , Long QT Syndrome/chemically induced , Adolescent , Benzodiazepines/adverse effects , Child , Child, Preschool , Dibenzothiazepines/adverse effects , Female , Follow-Up Studies , Humans , Male , Olanzapine , Quetiapine Fumarate , Risperidone/adverse effectsABSTRACT
OBJECTIVE: The aim of this study was to evaluate metabolic and hormonal side effects in children and adolescents after 6 months of treatment with 3 different second-generation antipsychotics (SGAs). METHOD: 66 children and adolescents (44 male [66.7%], mean +/- SD age = 15.2 +/- 2.9 years) treated for 6 months with risperidone (N = 22), olanzapine (N = 20), or quetiapine (N = 24) composed the study sample. 34 patients (51.5%) suffered from schizophrenia or other psychosis (according to DSM-IV criteria). Patients were consecutively attending different programs from March 2005 to October 2006. Prior to enrollment in the study, patients were either antipsychotic-naive (37.9%, N = 25) or had been taking an antipsychotic drug for fewer than 30 days. Significant weight gain was defined as a > or = 0.5 increase in body mass index (BMI) z score (adjusted for age and gender) at 6 months. Based on recent criteria for pediatric populations, patients were considered "at risk for adverse health outcome" if they met at least 1 of the following criteria: (1) > or = 85th BMI percentile plus presence of 1 or more negative weight-related clinical outcomes, or (2) > or = 95th BMI percentile. RESULTS: After the 6 months, BMI z scores increased significantly in patients receiving olanzapine and risperidone. At the 6-month follow-up, 33 patients (50.0%) showed significant weight gain. The number of patients at risk for adverse health outcome increased from 11 (16.7%) to 25 (37.9%) (p = .018). The latter increase was significant only in the olanzapine group (p = .012). Total cholesterol levels increased significantly in patients receiving olanzapine (p = .047) and quetiapine (p = .016). Treatment with quetiapine was associated with a significant decrease in free thyroxin (p = .011). CONCLUSION: Metabolic and hormonal side effects of SGAs in children and adolescents should be carefully monitored when prescribing these drugs.
Subject(s)
Benzodiazepines/adverse effects , Dibenzothiazepines/adverse effects , Obesity/chemically induced , Obesity/epidemiology , Psychotic Disorders/drug therapy , Psychotic Disorders/epidemiology , Risperidone/adverse effects , Schizophrenia/drug therapy , Schizophrenia/epidemiology , Adolescent , Benzodiazepines/therapeutic use , Blood Glucose/analysis , Body Mass Index , Child , Diagnostic and Statistical Manual of Mental Disorders , Dibenzothiazepines/therapeutic use , Female , Follow-Up Studies , Humans , Male , Olanzapine , Prevalence , Psychotic Disorders/diagnosis , Quetiapine Fumarate , Risperidone/therapeutic use , Schizophrenia/diagnosis , Substance-Related Disorders/epidemiology , Thyroxine/deficiency , Triglycerides/bloodABSTRACT
There has been a remarkable increase in prescription rates of antipsychotics in children and adolescents in recent years. Their side effects are a neglected area of research in this population, despite its vulnerability. In this cross-sectional study, we compared the presence of side effects in 60 children and adolescents who had taken antipsychotic medication for less than 1 month and 66 who had been receiving treatment with antipsychotics for more than 12 months. Mean age for the total sample was 15.62 years (SD 1.85). Groups did not differ in age, gender, or diagnosis. A total of 21.7% of short-term treatment group patients and 37.9% of longer-term treatment group patients presented mild dyskinetic movements (p = 0.004). Hyperprolactinemia was present in 78.6% and 48.5% in the short-term and longer-term treatment groups, respectively. Body mass index (p < 0.001), cholesterol levels (p < 0.001), and low-density lipoprotein-cholesterol (LDL-C) (p = 0.018) were higher in the longer-term treatment group. The use of these drugs in these populations merits careful scrutiny.
