Metabolic and Cardiovascular Adverse Events Associated With Antipsychotic Treatment in Children and Adolescents

Abstract

Antipsychotics are associated with several metabolic and cardiovascular-related adverse events in pediatric populations, especially when multiple antipsychotics or classes of psychotropic medications are coprescribed, controlling for individual risk factors.

Cardiovascular Events Following Treatment Initiation with Atypical Antipsychotic Medications in Publicly Insured U.S. Youth

“…Nevertheless, our findings are consistent with a previous study that compared 4140 youth treated with antipsychotics (conventional or AAPs) to a random sample of 4500 youth not treated with psychotropic medications with respect to the receipt of a cardiovascular diagnosis (McIntyre and Jerrell 2008). In that study, antipsychotic use was associated with an increased risk of youth being diagnosed with cardiovascular disorders (McIntyre and Jerrell 2008). While pediatric data from population-based studies are scarce, there are noteworthy data from short-term clinical studies in youth showing substantial increases in cardiometabolic parameters following AAP use.…”

“…In our study, cardiovascular events were assessed from hospitalizations and emergency department visits to reflect on the seriousness of the events and to avoid outpatient visit claims that may be related to monitoring or diagnostic work-up. Nevertheless, our findings are consistent with a previous study that compared 4140 youth treated with antipsychotics (conventional or AAPs) to a random sample of 4500 youth not treated with psychotropic medications with respect to the receipt of a cardiovascular diagnosis (McIntyre and Jerrell 2008). In that study, antipsychotic use was associated with an increased risk of youth being diagnosed with cardiovascular disorders (McIntyre and Jerrell 2008).…”

Cardiovascular Events Following Treatment Initiation with Atypical Antipsychotic Medications in Publicly Insured U.S. Youth

“…Nevertheless, our findings are consistent with a previous study that compared 4140 youth treated with antipsychotics (conventional or AAPs) to a random sample of 4500 youth not treated with psychotropic medications with respect to the receipt of a cardiovascular diagnosis (McIntyre and Jerrell 2008). In that study, antipsychotic use was associated with an increased risk of youth being diagnosed with cardiovascular disorders (McIntyre and Jerrell 2008). While pediatric data from population-based studies are scarce, there are noteworthy data from short-term clinical studies in youth showing substantial increases in cardiometabolic parameters following AAP use.…”

“…In our study, cardiovascular events were assessed from hospitalizations and emergency department visits to reflect on the seriousness of the events and to avoid outpatient visit claims that may be related to monitoring or diagnostic work-up. Nevertheless, our findings are consistent with a previous study that compared 4140 youth treated with antipsychotics (conventional or AAPs) to a random sample of 4500 youth not treated with psychotropic medications with respect to the receipt of a cardiovascular diagnosis (McIntyre and Jerrell 2008). In that study, antipsychotic use was associated with an increased risk of youth being diagnosed with cardiovascular disorders (McIntyre and Jerrell 2008).…”

Lipid Disturbances in Adolescents Treated With Second-Generation Antipsychotics

“…In accordance with a previous study conducted in our department, which included mainly adult patients 31 , the risk of developing hypercholesterolemia was significantly greater for females than for males. These findings are also consistent with results from a retrospective adolescent cohort 24 and with other studies, albeit controversial, suggesting that women have a greater vulnerability to develop psychotropic drug-induced metabolic disturbances than men 12,17,45 .…”

Metabolic adverse events associated with antipsychotic polypharmacy versus monotherapy among new pediatric users

“…The crude incidence rate of metabolic adverse events was found to be 5.83% within one year of antipsychotic initiation, which was similar to those reported in other studies [6,31]. However, the adjusted hazard ratios of developing metabolic adverse events during monotherapy and polypharmacy exposure time were not statistically significant, but trended towards an increased risk with polypharmacy use.…”

Cardiovascular Events Following Treatment Initiation with Atypical Antipsychotic Medications in Publicly Insured U.S. Youth

“…Nevertheless, our findings are consistent with a previous study that compared 4140 youth treated with antipsychotics (conventional or AAPs) to a random sample of 4500 youth not treated with psychotropic medications with respect to the receipt of a cardiovascular diagnosis (McIntyre and Jerrell 2008). In that study, antipsychotic use was associated with an increased risk of youth being diagnosed with cardiovascular disorders (McIntyre and Jerrell 2008). While pediatric data from population-based studies are scarce, there are noteworthy data from short-term clinical studies in youth showing substantial increases in cardiometabolic parameters following AAP use.…”

“…In our study, cardiovascular events were assessed from hospitalizations and emergency department visits to reflect on the seriousness of the events and to avoid outpatient visit claims that may be related to monitoring or diagnostic work-up. Nevertheless, our findings are consistent with a previous study that compared 4140 youth treated with antipsychotics (conventional or AAPs) to a random sample of 4500 youth not treated with psychotropic medications with respect to the receipt of a cardiovascular diagnosis (McIntyre and Jerrell 2008). In that study, antipsychotic use was associated with an increased risk of youth being diagnosed with cardiovascular disorders (McIntyre and Jerrell 2008).…”

Lipid Disturbances in Adolescents Treated With Second-Generation Antipsychotics

“…In accordance with a previous study conducted in our department, which included mainly adult patients 31 , the risk of developing hypercholesterolemia was significantly greater for females than for males. These findings are also consistent with results from a retrospective adolescent cohort 24 and with other studies, albeit controversial, suggesting that women have a greater vulnerability to develop psychotropic drug-induced metabolic disturbances than men 12,17,45 .…”

Metabolic adverse events associated with antipsychotic polypharmacy versus monotherapy among new pediatric users

“…The crude incidence rate of metabolic adverse events was found to be 5.83% within one year of antipsychotic initiation, which was similar to those reported in other studies [6,31]. However, the adjusted hazard ratios of developing metabolic adverse events during monotherapy and polypharmacy exposure time were not statistically significant, but trended towards an increased risk with polypharmacy use.…”

Cardiovascular Events Following Treatment Initiation with Atypical Antipsychotic Medications in Publicly Insured U.S. Youth

“…Nevertheless, our findings are consistent with a previous study that compared 4140 youth treated with antipsychotics (conventional or AAPs) to a random sample of 4500 youth not treated with psychotropic medications with respect to the receipt of a cardiovascular diagnosis (McIntyre and Jerrell 2008). In that study, antipsychotic use was associated with an increased risk of youth being diagnosed with cardiovascular disorders (McIntyre and Jerrell 2008). While pediatric data from population-based studies are scarce, there are noteworthy data from short-term clinical studies in youth showing substantial increases in cardiometabolic parameters following AAP use.…”

“…In our study, cardiovascular events were assessed from hospitalizations and emergency department visits to reflect on the seriousness of the events and to avoid outpatient visit claims that may be related to monitoring or diagnostic work-up. Nevertheless, our findings are consistent with a previous study that compared 4140 youth treated with antipsychotics (conventional or AAPs) to a random sample of 4500 youth not treated with psychotropic medications with respect to the receipt of a cardiovascular diagnosis (McIntyre and Jerrell 2008). In that study, antipsychotic use was associated with an increased risk of youth being diagnosed with cardiovascular disorders (McIntyre and Jerrell 2008).…”

Lipid Disturbances in Adolescents Treated With Second-Generation Antipsychotics

“…In accordance with a previous study conducted in our department, which included mainly adult patients 31 , the risk of developing hypercholesterolemia was significantly greater for females than for males. These findings are also consistent with results from a retrospective adolescent cohort 24 and with other studies, albeit controversial, suggesting that women have a greater vulnerability to develop psychotropic drug-induced metabolic disturbances than men 12,17,45 .…”

Metabolic adverse events associated with antipsychotic polypharmacy versus monotherapy among new pediatric users

“…The crude incidence rate of metabolic adverse events was found to be 5.83% within one year of antipsychotic initiation, which was similar to those reported in other studies [6,31]. However, the adjusted hazard ratios of developing metabolic adverse events during monotherapy and polypharmacy exposure time were not statistically significant, but trended towards an increased risk with polypharmacy use.…”