Integrative Management of Metabolic Syndrome in Youth Prescribed Second-Generation Antipsychotics

Rice, Jessie; Ramtekkar, Ujjwal

doi:10.3390/medsci8030034

Cited by 1 publication

(1 citation statement)

References 95 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nutritional supplements with data in pediatric obesity, though not yet tested in the context of AP treatment, are also reviewed. The interventions with the best support in reducing childhood obesity and subsequent metabolic symptoms include an increased level of physical activity, improved sleep, and a diet consisting of fruits, vegetables, whole grains, and fish oil supplementation (267). Generalizing from healthy populations must be done with caution, however, as psychiatric diagnoses and psychosocial stressors may result in poorer outcomes of lifestyle interventions.…”

Section: Non-pharmacological Treatmentsmentioning

confidence: 99%

The Burden of Antipsychotic-Induced Weight Gain and Metabolic Syndrome in Children

Libowitz

Nurmi

2021

Front. Psychiatry

View full text Add to dashboard Cite

Antipsychotic medications are critical to child and adolescent psychiatry, from the stabilization of psychotic disorders like schizophrenia, bipolar disorder, and psychotic depression to behavioral treatment of autism spectrum disorder, tic disorders, and pediatric aggression. While effective, these medications carry serious risk of adverse events—most commonly, weight gain and cardiometabolic abnormalities. Negative metabolic consequences affect up to 60% of patients and present a major obstacle to long-term treatment. Since antipsychotics are often chronically prescribed beginning in childhood, cardiometabolic risk accumulates. An increased susceptibility to antipsychotic-induced weight gain (AIWG) has been repeatedly documented in children, particularly rapid weight gain. Associated cardiometabolic abnormalities include central obesity, insulin resistance, dyslipidemia, and systemic inflammation. Lifestyle interventions and medications such as metformin have been proposed to reduce risk but remain limited in efficacy. Furthermore, antipsychotic medications touted to be weight-neutral in adults can cause substantial weight gain in children. A better understanding of the biological underpinnings of AIWG could inform targeted and potentially more fruitful treatments; however, little is known about the underlying mechanism. As yet, modest genetic studies have nominated a few risk genes that explain only a small percentage of the risk. Recent investigations have begun to explore novel potential mechanisms of AIWG, including a role for gut microbiota and microbial metabolites. This article reviews the problem of AIWG and AP metabolic side effects in pediatric populations, proposed mechanisms underlying this serious side effect, and strategies to mitigate adverse impact. We suggest future directions for research efforts that may advance the field and lead to improved clinical interventions.

show abstract

Section: Non-pharmacological Treatmentsmentioning

confidence: 99%