Antipsychotic-Related Abnormal Involuntary Movements and Metabolic and Endocrine Side Effects in Children and Adolescents

Laita, P.; Cifuentes, Alicia; Doll, A.; Llorente, Cloe; Cortes, Irene; Parellada, Mara; Moreno, Dolores; Ruiz-Sancho, Ana; Graell, Montserrat; Arango, Celso

doi:10.1089/cap.2006.0039

Cited by 61 publications

(52 citation statements)

References 35 publications

(28 reference statements)

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“…This may indicate a higher susceptibility to extrapyramidal symptoms with olanzapine as compared to quetiapine in this population. In a previous study on SGA tolerability in a pediatric population, we reported that patients treated mostly with SGAs over a one-year showed more dyskinetic movements than patients treated for less than 1 month [22]. Maturation of the dopamine system during childhood and adolescence may affect susceptibility to motor side effects differently, depending on age.…”

Section: Discussionmentioning

confidence: 92%

Olanzapine compared to quetiapine in adolescents with a first psychotic episode

Arango

Robles

Parellada

et al. 2009

Eur Child Adolesc Psychiatry

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Objective: To compare the efficacy, safety, and tolerability of olanzapine and quetiapine in adolescents with first episode psychosis. Method: Fifty adolescents (age 16 ± 1.25) with a first episode of psychosis were randomized to quetiapine or olanzapine in a 6-month open label study. Efficacy and side effect scales, as well as vital signs and laboratory data were recorded at baseline, 7, 15, 30, 90, and 180 days (end of study). Results: Out of the total sample included in the study, 32 patients completed the trial (quetiapine n = 16, olanzapine n = 16). Patients in both treatment groups had a significant reduction in all clinical scales with the exception of the negative scale of the Positive and Negative Symptom Scale (PANSS) for olanzapine and the general psychopathology scale of the PANSS for quetiapine. The only difference between treatment arms on the clinical scales was observed on the patients' strength and difficulties questionnaire (SDQ) scale, with greater improvement for olanzapine. Patients on olanzapine gained 15.5 kg and patients on quetiapine gained 5.5 kg. Conclusion: Olanzapine and quetiapine reduced psychotic symptoms in this adolescent sample. Patients on olanzapine gained significantly more weight. Side effects with both drugs seemed to be more prevalent than those reported in adult studies

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Section: Discussionmentioning

confidence: 92%

Olanzapine compared to quetiapine in adolescents with a first psychotic episode

Arango

Robles

Parellada

et al. 2009

Eur Child Adolesc Psychiatry

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“…[11][12][13]. Best practice guidelines were considered as being met if the clinician indicated that he or she was performing a regular laboratory evaluation or was aware that another physician was performing it.…”

Section: Discussionmentioning

confidence: 99%

“…[9][10][11] Another source of concern pertains to the adverse effects of antipsychotic medications, some of which may be more common in youth compared with adults. These adverse effects include movement disorders, 12 metabolic problems, weight gain, 13 and sedation.…”

Section: What This Study Addsmentioning

confidence: 99%

Antipsychotic Medication Prescribing in Children Enrolled in Medicaid

et al. 2015

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BACKGROUND: Although the increase in treatment of children and adolescents with antipsychotic medications has been well documented, much less is known about the factors related to the use of these agents and how closely the treatment follows best practice recommendations.METHODS: Prescribers of each antipsychotic medication prescription issued for a Medicaidinsured child in Vermont aged ,18 years were sent a prior authorization survey that assessed several domains including the clinical indication, other treatments, metabolic monitoring, prescriber specialty, and prescription origin. These variables were combined to categorize prescriptions as following indications approved by the US Food and Drug Administration (FDA) and best practice guidelines. RESULTS:The response rate of the survey was 80%, with 677 surveys from 147 prescribers available for analysis; more than one-half of the respondents were primary care clinicians. Overall, the clinical indication for an antipsychotic prescription followed best practice guidelines 91.7% of the time, with overall best practice guidelines followed at a rate of 50.1%. An FDA indication was followed in 27.2% of cases. Psychiatrists were significantly more likely to follow best practice guidelines than nonpsychiatrists. Antipsychotic medications were typically used only after other pharmacologic and nonpharmacologic treatments were ineffective, although previous treatment with cognitive-behavioral therapy was uncommon (15.5%). Metabolic monitoring that included serial laboratory tests was reported in 57.2% of cases.CONCLUSIONS: Current prescribing patterns of antipsychotic medications for children and adolescents follow best practice guidelines approximately one-half of the time, with nonadherence often related to lack of metabolic monitoring. WHAT'S KNOWN ON THIS SUBJECT:Although the rates of antipsychotic medication treatment are rising for children and adolescents, little is known about the factors associated with this practice. WHAT THIS STUDY ADDS:This study provides some of the first data regarding when and why clinicians decide to use antipsychotic medications. It reveals clues as to how prescribing might better follow best practice guidelines.

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“…Weight increase in children raises the concern that, if treated for long periods, these patients are at higher risk of insulin resistance, diabetes, hypertension or cardiovascular disease in the future. If drugs likely to induce weight gain have to be used, compensatory behavioral or pharmacological approaches should be implemented (Correll 2007;Laita et al 2007). …”

Section: Antipsychotics In Child Psychotic Episodes 333mentioning

confidence: 99%

Antipsychotic Treatment in Child and Adolescent First-Episode Psychosis: A Longitudinal Naturalistic Approach

Castro‐Fornieles

Parellada

Soutullo

et al. 2008

Journal of Child and Adolescent Psychopharmacology

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This meta-analysis assessed aggression and/or hostility-related events in children and adolescents treated with fluoxetine (n = 376) compared with placebo (n = 255). Aggression and/or hostility-related events were identified in 2.1% of fluoxetine versus 3.1% of placebo-treated patients (p = 0.588). This analysis fails to support an association between fluoxetine treatment and increased risk of aggression and/or hostility-related events in children and adolescents compared with placebo.

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Antipsychotic-Related Abnormal Involuntary Movements and Metabolic and Endocrine Side Effects in Children and Adolescents

Cited by 61 publications

References 35 publications

Olanzapine compared to quetiapine in adolescents with a first psychotic episode

Olanzapine compared to quetiapine in adolescents with a first psychotic episode

Antipsychotic Medication Prescribing in Children Enrolled in Medicaid

Antipsychotic Treatment in Child and Adolescent First-Episode Psychosis: A Longitudinal Naturalistic Approach

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