Efficacy and safety of second-generation antipsychotics in children and adolescents with psychotic and bipolar spectrum disorders: Comprehensive review of prospective head-to-head and placebo-controlled comparisons

Fraguas, David; Correll, Christoph U.; Merchán-Naranjo, Jessica; Rapado-Castro, Marta; Parellada, Mara; Moreno, Carmen; Arango, Celso

doi:10.1016/j.euroneuro.2010.07.002

Cited by 179 publications

(128 citation statements)

References 96 publications

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“…Over recent decades, antipsychotic prescriptions have sharply increased, not only to treat childhood-onset schizophrenia, but have also been widely used in children and adolescents to treat mental disorders such as bipolar disorder, autism and attention deficit hyperactivity disorder [1][2][3][4]. The majority of antipsychotic drugs prescribed in children and adolescents are second generation antipsychotics (SGAs) including risperidone and olanzapine, which have serious weight gain and other metabolic side-effects [5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Risperidone-induced weight gain and reduced locomotor activity in juvenile female rats: The role of histaminergic and NPY pathways

Lian

Santis

et al. 2015

Pharmacological Research

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. (2015). Risperidone-induced weight gain and reduced locomotor activity in juvenile female rats: the role of histaminergic and NPY pathways. Pharmacological Research,[95][96] Risperidone-induced weight gain and reduced locomotor activity in juvenile female rats: the role of histaminergic and NPY pathways AbstractSecond generation antipsychotic drugs (SGAs) such as risperidone are increasingly prescribed (mostly for offlabel use) to children and adolescents for treating various mental disorders. SGAs cause serious weight gain/ obesity and other metabolic side-effects. This study aimed to establish an animal model of risperidoneinduced weight gain in female juvenile rats, and to investigate the effects of risperidone on the expression of hypothalamic histaminergic H1 receptors (H1R) and neuropeptides, and their association with weight gain. Female Sprague Dawley rats were treated orally with risperidone (0.3 mg/kg, 3 times/day) or vehicle (control) starting from postnatal day (PD) 23 (±1 day) for 3 weeks (a period corresponding to the childhoodadolescent period in humans). In the female juvenile rats, risperidone treatment increased food intake and body weight gain, which started to appear after 12 days' treatment. Risperidone also significantly decreased the locomotor activity of the female rats. Consistently, risperidone significantly elevated mRNA expression of hypothalamic H1R, neuropeptide Y (NPY), and agouti-related peptide (AgRP) compared to controls, and H1R and NPY levels were correlated with risperidone enhanced weight gain and food intake in the female juvenile rats. However, risperidone did not affect hypothalamic proopiomelanocortin (POMC) and cocaineand amphetamine-regulated transcript (CART) mRNA expression. Therefore, these results suggested that risperidone elevated appetite and body weight gain in juveniles via regulation of the hypothalamic H1R, NPY and AgRP pathways, as well as by reducing activity.

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Section: Introductionmentioning

confidence: 99%

Risperidone-induced weight gain and reduced locomotor activity in juvenile female rats: The role of histaminergic and NPY pathways

Lian

Santis

et al. 2015

Pharmacological Research

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“…The side effects of psychotropic drugs are another cause for increased medical morbidity in this paediatric population. This has been clearly shown with antipsychotics [2] but is also the case for all other psychotropics. Finally, some mental disorders are direct causes of medical complications.…”

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confidence: 62%

Physical comorbidity in mental illness in paediatric population: need for an integrated health care approach to paediatrics and child psychiatry

Arango

2011

Eur Child Adolesc Psychiatry

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“…Generally, a 6-to 8-week course of an antimanic agent, at appropriate doses, is recommended before adding or replacing it with another drug. 5,[73][74][75] The lack of replication of results of RPCTs and the lack of head-to-head comparisons of different psychopharmacologic approaches precludes the designation of any therapeutic option as having stronger evidence supporting its use in the treatment of BD in children. However, it bears stressing that, in Brazil, the only drugs provided through the national Unified Health System (SUS) are lithium, carbamazepine, and valproate.…”

Section: Discussionmentioning

confidence: 99%

Pharmacotherapy of bipolar disorder in children and adolescents: an update

Peruzzolo

Tramontina

Rohde

et al. 2013

Rev. Bras. Psiquiatr.

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Objective: To review the options for acute and maintenance pharmacological treatment of bipolar disorder in children and adolescents, including the treatment of bipolar depression and comorbid attention deficit/hyperactivity disorder (ADHD). Methods: Narrative review of randomized clinical trials and open-label studies published from 2000 to 2012. The PubMed and PsycINFO websites were queried. Case series were included when a higher level of evidence was not available. Results: Published data from randomized controlled trials (RCTs) in acute mania/hypomania with significant responses are available for lithium, topiramate, risperidone, olanzapine, and aripiprazole. Open trials of lithium and lamotrigine show that these drugs may be effective in the treatment of depressive episodes. No trials of selective serotonin reuptake inhibitors (SSRIs) have been conducted. In the treatment of comorbid ADHD, there are encouraging findings with mixed amphetamine salts and atomoxetine; conflicting results are observed with methylphenidate. Conclusions: Published RCTs of traditional mood stabilizers are scarce, but the best available evidence (results from meta-analytic regression) suggests that second-generation antipsychotics (SGAs) as a group are more effective in reducing manic symptoms. Risperidone was the only one included in head-to-head comparisons (vs. lithium and divalproex), showing superiority in terms of efficacy, but with more metabolic side effects, which were also more common in most of the SGAs. There are few studies addressing the treatment of ADHD and depression. Brazilian guidelines for the treatment of pediatric bipolar disorder should also include some SGAs (especially risperidone and aripiprazole) as first-line treatment, and these drugs should be provided by the public health services.

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Efficacy and safety of second-generation antipsychotics in children and adolescents with psychotic and bipolar spectrum disorders: Comprehensive review of prospective head-to-head and placebo-controlled comparisons

Cited by 179 publications

References 96 publications

Risperidone-induced weight gain and reduced locomotor activity in juvenile female rats: The role of histaminergic and NPY pathways

Risperidone-induced weight gain and reduced locomotor activity in juvenile female rats: The role of histaminergic and NPY pathways

Physical comorbidity in mental illness in paediatric population: need for an integrated health care approach to paediatrics and child psychiatry

Pharmacotherapy of bipolar disorder in children and adolescents: an update

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