Metabolic and Hormonal Side Effects in Children and Adolescents Treated With Second-Generation Antipsychotics
J Clin Psychiatry 2008;69(7):1165-1175
© Copyright 2017 Physicians Postgraduate Press, Inc.
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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
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 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) 85th BMI percentile plus presence of
1 or more negative weight-related clinical outcomes, or (2) 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
Conclusion: Metabolic and hormonal
side effects of SGAs in children and adolescents should be carefully monitored when
prescribing these drugs.