Metabolic effects of second‐generation antipsychotics in bipolar youth: comparison with other psychotic and nonpsychotic diagnoses

Moreno, Carmen; Merchán-Naranjo, Jessica; Álvarez, Mar; Baeza, Inmaculada; Alda, José A; Martínez-Cantarero, Carmen; Parellada, Mara; Sánchez, Bernardo; Serna, Elena de la; Giráldez, Marisa; Arango, Celso

doi:10.1111/j.1399-5618.2010.00797.x

Cited by 48 publications

(31 citation statements)

References 53 publications

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“…These data are consistent with previous results from much smaller European samples in which SGA-related weight gain was observed in mainly Caucasian adolescents with bipolar and psychotic disorders (Schimmelmann et al 2007;Arango et al 2009;Moreno et al 2010). In contrast, our sample consisted mainly of children with autistic spectrum disorders treated with risperidone.…”

Section: Discussionsupporting

confidence: 93%

“…Similarly, in European studies, an elevated risk of weight gain, obesity, and metabolic side effects has been reported in pediatric patients with bipolar disorder and psychotic disorders using SGAs. (Schimmelmann et al 2007;Arango et al 2009;Moreno et al 2010) On the other hand, European data are missing regarding the risk of overweight in pediatric populations with a psychiatric diagnosis with and without use of SGAs.…”

Section: Introductionmentioning

confidence: 97%

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Differences in Body Mass Index z-Scores and Weight Status in a Dutch Pediatric Psychiatric Population With and Without Use of Second-Generation Antipsychotics

Hoogd

Overbeek

Heerdink

et al. 2012

Journal of Child and Adolescent Psychopharmacology

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These data show robust and significant differences in sex- and age-adjusted body weight and weight status in young pediatric Caucasian samples with and without use of SGAs independent of Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR) (American Psychiatric Association 2000 ) diagnosis and nonantipsychotic medications. Weight status and metabolic effects of SGAs require careful attention, especially in youth.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 97%

Differences in Body Mass Index z-Scores and Weight Status in a Dutch Pediatric Psychiatric Population With and Without Use of Second-Generation Antipsychotics

Hoogd

Overbeek

Heerdink

et al. 2012

Journal of Child and Adolescent Psychopharmacology

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“…That was also the case for the combination with anticonvulsants, where sedation was found to be more frequent in patients on polypharmacy. However, it must be noted that most of these studies were of short duration, thus preventing the detection of some relevant long-term risks of the combination of SSRIs with SGAs and MSs such as metabolic AEs (Moreno et al 2010).…”

Section: Potential Risks Associated With Polypharmacy With Antidepresmentioning

confidence: 99%

Polypharmacy with antidepressants in children and adolescents

Díaz‐Caneja

Espliego

Parellada

et al. 2012

Int. J. Neuropsychopharm.

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The aim of this study was to review current epidemiological data on the use of antidepressants in co-prescription with other psychotropic drugs in children and adolescents, as well as available efficacy and safety information. A Medline search from inception until February 2012 was performed to identify epidemiological and clinical studies, reviews and reports containing potentially relevant information on polypharmacy with antidepressants in young people. There has been an increase in polypharmacy in children and adolescents involving antidepressants in recent years. Antidepressants have become one of the drug classes most frequently prescribed in combination and are commonly co-prescribed with stimulants and antipsychotics. Most information regarding efficacy and safety of polypharmacy patterns was provided by case series and open-label studies. Efficacy studies gave some support for the use of a combination of antidepressants and antipsychotics in the management of refractory obsessive-compulsive disorder and some residual symptoms in major depressive disorder. Even less empirical support was found for a combination of stimulants and antidepressants in co-morbid attention deficit hyperactivity disorder and mood or anxiety disorders. Adverse events were similar to those found with individual medication groups, with severe adverse events mostly reported by individual case reports. The use of polypharmacy with antidepressants has become a regular practice in clinical settings. Although there is still little efficacy and safety information, preliminary evidence points to the potential clinical usefulness of some polypharmacy patterns. Further research on patients with co-morbidities or more severe conditions is needed, in order to improve knowledge of this issue.

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“…Tan solo hay un número limitado de estudios, en su mayoría recientes, que han evaluado directamente el impacto de los ASG en estos componentes del SM en pacientes jóvenes. Los ASG que se asociaron a un mayor cambio de peso parecieron producir también los efectos más notables sobre la glucosa y los lípidos 25,93,98 .…”

Section: Efectos Adversos Metabólicos Y Componentes Del Síndrome Metaunclassified

Efectos adversos metabólicos y endocrinos de los antipsicóticos de segunda generación en niños y adolescentes: una revisión sistemática de ensayos aleatorizados, controlados con placebo y guías de práctica clínica

Hert

Dobbelaere²,

Sheridan

et al. 2011

Psiquiatría Biológica

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información del artículoPalabras clave: Adolescentes Antipsicóticos Enfermedad cardiovascular Niños Diabetes Guías Manejo Monitorización Efectos secundarios Aumento de peso r e s u m e n Los antipsicóticos de segunda generación (ASG) se están utilizando con mayor frecuencia de lo que nunca se había hecho en niños y en adolescentes con trastornos psicóticos y con una amplia variedad de trastornos no psicóticos. Varios ASG han sido autorizados por las autoridades reguladoras para indicaciones pediátricas en diversos países, pero todavía es común su uso fuera de las indicaciones aprobadas. El objetivo de este estudio fue realizar una revisión sistemática y evaluar críticamente la literatura existente sobre los efectos secundarios cardiometabólicos y endocrinos de los ASG en niños y en adolescentes, mediante una búsqueda bibliográfica en Medline/Pubmed/Google Scholar para identificar los ensayos aleatorizados y controlados con placebo de antipsicóticos en niños y adolescentes (edad <18 años) publicados hasta febrero de 2010. Se identificaron 31 estudios aleatorizados y controlados, con un total de 3.595 pacientes pediátricos. La revisión de estos datos confirmó que los ASG se asocian a efectos secundarios cardiometabólicos y endocrinos relevantes y que, en los niños y en los adolescentes, los antipsicóticos muestran una tendencia elevada a inducir hiperprolactinemia, aumento de peso y alteraciones metabó-licas asociadas. Tan solo se han presentado datos relativos al cambio de peso de manera suficiente para poder llevar a cabo un metaanálisis formal. En 24 ensayos con un total de 3.048 pacientes pediátricos de diversas edades y diagnósticos, la ziprasidona fue el fármaco que se asoció a un menor cambio de peso (−0,04 kg, intervalo de confianza [IC] del 95%: −0,38 a +0,30), seguido del aripiprazol (0,79 kg, IC del 95%: 0,54 a 1,04], la quetiapina (1,43 kg, IC del 95%: 1,17 a 1,69) y la risperidona (1,76 kg, IC del 95%: 1,27 a 2,25) con valores intermedios, mientras que la olanzapina fue el que se asoció a un aumento de peso mayor (3,45 kg, IC del 95%: 2,93 a 3,97). El aumento de peso significativo fue más prevalente en los pacientes con trastorno autista de menor edad y probablemente con menor exposición previa a antipsicóticos. Estos datos sugieren claramente que está justificado un examen de detección y una monitorización rigurosos de los posibles efectos secundarios metabólicos y que siempre que sea posible deben usarse en primer lugar los medicamentos que causan menos problemas desde el punto de vista cardiometabólico. La buena colaboración entre psiquiatras de la infancia y la adolescencia, médicos generales y pediatras es esencial para optimizar los resultados globales y reducir la probabilidad de morbimortalidad cardiovascular prematura. a b s t r a c tSecond-generation antipsychotics (SGA) are being used more often than ever before in children and adolescents with psychotic and a wide range of non-psychotic disorders. Several SGA have received ଝ Publicado previamente en European

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Metabolic effects of second‐generation antipsychotics in bipolar youth: comparison with other psychotic and nonpsychotic diagnoses

Abstract: There are early weight gain and metabolic changes across diagnoses in youth treated with SGAs.

Cited by 48 publications

References 53 publications

Differences in Body Mass Index z-Scores and Weight Status in a Dutch Pediatric Psychiatric Population With and Without Use of Second-Generation Antipsychotics

Differences in Body Mass Index z-Scores and Weight Status in a Dutch Pediatric Psychiatric Population With and Without Use of Second-Generation Antipsychotics

Polypharmacy with antidepressants in children and adolescents

Efectos adversos metabólicos y endocrinos de los antipsicóticos de segunda generación en niños y adolescentes: una revisión sistemática de ensayos aleatorizados, controlados con placebo y guías de práctica clínica

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