Antipsychotic Use in Children and Adolescents

Baeza, Inmaculada; Serna, Elena de la; Escalona, Rosa Calvo; Morer, Àstrid; Merchán-Naranjo, Jessica; Tapia, Cecilia; Martinez-Cantarero, M.; Andrés, Patrícia; Alda, José A; Sánchez, Bernardo; Arango, Celso; Castro‐Fornieles, Josefina

doi:10.1097/jcp.0000000000000190

Cited by 34 publications

(21 citation statements)

References 47 publications

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“…Detailed information about studies that had extreme (less than fifth percentile or greater than 95th percentile) prevalence is shown in Table S1. Studies reporting extremely low prevalence of polypharmacy were more likely to be large community‐level studies conducted in the United States or more likely to include individuals not on any medications than studies reporting extremely high prevalence . Additionally, studies reporting low prevalence were more likely to evaluate polypharmacy at the drug class level, sequentially, use overlapping periods longer than 30 days, or evaluate psychotropic medications compared with those with extremely high prevalence.…”

Section: Resultsmentioning

confidence: 99%

“…Studies reporting extremely low prevalence of polypharmacy were more likely to be large community-level studies conducted in the United States or more likely to include individuals not on any medications than studies reporting extremely high prevalence. [27][28][29][30][31][32][33][34][35][36][37][38][39][40] Additionally, studies reporting low prevalence were more likely to evaluate polypharmacy at the drug class level, sequentially, use overlapping periods longer than 30 days, or evaluate psychotropic medications compared with those with extremely high prevalence. On the other hand, studies reporting extremely high prevalence of polypharmacy were likely to be conducted in Asia, in inpatient settings, use overlapping periods less than 31 days, or assess polypharmacy in multiple complex chronic conditions, or multiple medication classes.…”

Section: Prevalence Of Polypharmacymentioning

confidence: 99%

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Variation of the prevalence of pediatric polypharmacy: A scoping review

Baker

Feinstein

et al. 2019

Pharmacoepidemiology and Drug

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Purpose To examine the range of prevalence of pediatric polypharmacy in literature through a scoping review, focusing on factors that contribute to its heterogeneity in order to improve the design and reporting of quality improvement, pharmacovigilance, and research studies. Methods We searched Ovid Medline, PubMed, EMBASE, CINAHL, Ovid PsycINFO, Cochrane CENTRAL, and Web of Science Core Collection databases for studies with concepts of children and polypharmacy, along with a hand search of the bibliographies of six reviews and 30 included studies. We extracted information regarding study design, disease conditions, and prevalence of polypharmacy. Results Two hundred eighty‐four studies reported prevalence of polypharmacy. They were more likely to be conducted in North America (37.7%), published after 2010 (44.4%), cross‐sectional (67.3%), in outpatient settings (59.5%). Prevalence ranged from 0.9% to 98.4%, median 39.7% (interquartile range [IQR] 22.0%‐54.0%). Studies from Asia reported the highest median prevalence of 45.4% (IQR 27.3%‐61.0%) while studies from North America reported the lowest median prevalence of 30.4% (IQR 14.7%‐50.2%). Prevalence decreased over time: median 45.6% before 2001, 38.1% during 2001 to 2010, and 34% during 2011 to 2017. Studies involving children under 12 years had a higher median prevalence (46.9%) than adolescent studies (33.7%). Inpatient setting studies had a higher median prevalence (50.3%) than studies in outpatient settings (38.8%). Community level samples, higher number and duration of medications defining polypharmacy, and psychotropic medications were associated with lower prevalence. Conclusions The prevalence of pediatric polypharmacy is high and variable. Studies reporting pediatric polypharmacy should account for context, design, polypharmacy definition, and medications evaluated.

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Section: Resultsmentioning

confidence: 99%

Section: Prevalence Of Polypharmacymentioning

confidence: 99%

Variation of the prevalence of pediatric polypharmacy: A scoping review

Baker

Feinstein

et al. 2019

Pharmacoepidemiology and Drug

View full text Add to dashboard Cite

show abstract

“…The protracted developmental trajectory of dopaminergic projections in rodents (Tseng and O’Donnell, 2007; Benoit-Marand and O’Donnell, 2008; Huppe-Gourgues and O’Donnell, 2012) and humans (Casey et al, 2010; Galvan, 2010) makes these circuits especially vulnerable to the effects of psychotropic drug treatment during adolescence. Second-generation atypical antipsychotic drugs (AAPDs), such as olanzapine (OLA), are commonly prescribed for adolescent psychosis (Baeza et al, 2014) and are often used off-label for a variety of other neuropsychiatric and behavioral indications (Domino and Swartz, 2008; Olfson et al, 2010). Although studies of adolescent antipsychotic treatment have increased over recent years, the primary focus of this research has been on drug efficacy and tolerance.…”

Section: Introductionmentioning

confidence: 99%

Olanzapine Treatment of Adolescent Rats Alters Adult D2 Modulation of Cortical Inputs to the Ventral Striatum

Brooks

O’Donnell

Frost

2016

IJNPPY

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Background:The striatal dopamine system undergoes vast ontogenetic changes during adolescence, making the brain vulnerable to drug treatments that target this class of neurotransmitters. Atypical antipsychotic drugs are often prescribed to children and adolescents for off-label treatment of neuropsychiatric disorders, yet the long-term impact this treatment has on brain development remains largely unknown.Methods:Adolescent male rats were treated with olanzapine or vehicle for 3 weeks (during postnatal day 28–49) using a dosing condition designed to approximate closely D2 receptor occupancies in the human therapeutic range. We assessed D2 receptor modulation of corticostriatal inputs onto medium spiny neurons in the adult ventral striatum using in vitro whole-cell current clamp recordings.Results:The D2/D3 agonist quinpirole (5 µM) enhanced cortically driven medium spiny neuron synaptic responses in slices taken from adult rats treated with vehicle during adolescence, as in untreated adult rats. However, in slices from mature rats treated with olanzapine during adolescence, quinpirole reduced medium spiny neuron activation. The magnitude of decrease was similar to previous observations in untreated, prepubertal rats. These changes may reflect alterations in local inhibitory circuitry, as the GABA-A antagonist picrotoxin (100 µM) reversed the effects of quinpirole in vehicle-treated slices but had no impact on cortically evoked responses in olanzapine-treated slices.Conclusions:These data suggest that adolescent atypical antipsychotic drug treatment leads to enduring changes in dopamine modulation of corticostriatal synaptic function.

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“…1 Quetiapine is also widely used off label for treatment of various psychiatric disorders. [2][3][4] Angioedema is characterized by swelling of deep dermis and subcutaneous tissues without itching, often seen around the eyes, lips, and genitals where subcutaneous tissue is loose. 5 Histamine and bradykinin release by stimulation of mast cells via foods, drugs, infections, and physical stimuli lead to vascular permeability and dilatation.…”

Section: Quetiapine Associated With Angioedemamentioning

confidence: 99%