Open-Label Quetiapine in the Treatment of Children and Adolescents with Autistic Disorder

Martin, Andrés; Koenig, Kathleen; Scahill, Lawrence David; Bregman, Joel D.

doi:10.1089/cap.1999.9.99

Cited by 154 publications

(69 citation statements)

References 7 publications

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“…28 Likewise, quetiapine is associated with increased appetite and weight gain in children and adolescents with autistic disorder. 29 Thus, the hyperphagia and weight gain found in quetiapine-treated mice are similar to the findings in humans. The effects of these two agents on increasing appetite and weight in mice closely mimic the human response ( Figure 5).…”

Section: Discussionsupporting

confidence: 66%

“…The olanzapine-and quetiapine-induced weight gain in our model is associated with hyperphagia, which has been Antipsychotic drug-induced weight gain MB Cope et al documented in humans for both drugs. [28][29][30] Risperidone and ziprasidone caused significant weight gain but were not associated with hyperphagia, suggesting that these drugs may affect energy expenditure rather than intake in our model. More detailed energy expenditure measurements (activity levels, resting metabolic rate, and respiratory quotients) and cumulative food intake monitoring will be required to determine the effects of AAPDs on energy balance.…”

Section: Discussionmentioning

confidence: 99%

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Antipsychotic drug-induced weight gain: development of an animal model

et al. 2005

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OBJECTIVE: Weight gain is a prominent effect of most atypical antipsychotic drugs (AAPDs); yet, the mechanisms are not fully understood and no well-established mouse models exist for investigating the mechanisms. Thus, we developed a mouse model to evaluate the effects of AAPDs on eating, body weight (BW), and body composition. METHODS: Female C57BL/6J mice were used to test olanzapine, quetiapine, ziprasidone, and risperidone. Mice were acclimated to individual housing, given ad libitum access to chow and water, dosed with placebo peanut butter pills for 1 week, and then dosed daily with AAPD-laced peanut butter pills for 4 weeks. Weekly food intakes and BWs were measured, and body compositions were determined at the end of each experiment. RESULTS: After 4 weeks of treatment, olanzapine, quetiapine, ziprasidone, and risperidone caused significant weight increases, but only olanzapine and quetiapine were associated with significantly increased food intake. Body composition data revealed that olanzapine-treated mice had more relative fat mass and risperidone-treated mice had more relative lean mass than did control mice. Quetiapine and ziprasidone did not significantly affect relative body composition even though BW was increased. CONCLUSIONS: Oral AAPD administration causes increased BW in female mice. Our mouse model of AAPD-induced weight gain resembles the human response to these medications and will be used to investigate the mechanisms for weight gain and fat accumulation.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Antipsychotic drug-induced weight gain: development of an animal model

et al. 2005

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“…In an open-label study with six children receiving a mean dose of 225 mg/day for four months, only two had improvements in their pattern of aggression. 50 Another open-label study with nine adolescents used doses of 100 to 450 mg/day for 12 weeks. Only six adolescents completed the study, and only two of them were responders in the analysis of aggression.…”

Section: Risperidonementioning

confidence: 99%

“…Olanzapine Quetiapine Ziprasidone Aripiprazole Clozapine 43 (n = 6) 50 (n = 12) 52 (n = 5) 53 (n = 3) 56 (n = 12) 44 (n = 9) 51 (n = 32) 54 (n = 1) 57 CS/OL N = 3 -----(n = 80) 36 (n = 101) 38 (n = 79) 39 Conduct disorder CR/OL -N = 2 N = 2 ---(n = 16) 41 (n = 16) 47 (n = 23) 42 (n = 24)* 49 CS N = 2 ----(n = 118) 33 -(n = 10) 34 Mental retardation CR/OL ----+ (n = 18) + (n = 8) CS + (N = 1) ----- Table 4 for children and adolescents, despite the limitations discussed in the text. Except for clozapine, studies did not find differences in their potency, and choices should be based on their adverse events.…”

Section: Risperidonementioning

confidence: 99%

Atypical antipsychotics in the treatment of pathological aggression in children and adolescents: literature review and clinical recommendations

Teixeira

Jacintho

Celeri

et al. 2013

Trends Psychiatry Psychother.

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Objective: To review the literature about the use of atypical antipsychotics in the treatment of pathological aggression in children and adolescents. Method: The databases MEDLINE, SciELO, and LILACS were searched for publications in Portuguese or English from 1992 to August 2011 using the following keywords: mental disease, child, adolescent, treatment, atypical antipsychotic, aggressive behavior, aggression, and violent behavior. Results: Sixty-seven studies of good methodological quality and clinical interest and relevance were identified. Studies including children and adolescents were relatively limited, because few atypical antipsychotics have been approved by the Food and Drug Administration (FDA). All the medications included in this review (risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole and clozapine) have some effectiveness in treating aggression in children and adolescents, and choices should be based on clinical indications and side effects. Conclusions: There are few studies about the effectiveness and safety of atypical antipsychotics for the pediatric population, and further randomized controlled studies with larger groups of patients and more diagnostic categories, such as severe conduct disorder and oppositional defiant disorder, should be conducted to confirm the results reported up to date and to evaluate the impact of long-term use. Keywords: Aggression, violence, atypical antipsychotics, behavioral disorders, children, adolescents. ResumoObjetivo: Realizar uma revisão sistemática da literatura científica sobre o uso de antipsicóticos atípicos (APAs) no tratamento da agressividade patológica em crianças e adolescentes. Método: Foi realizada busca eletrônica nas bases de dados MEDLINE, SciELO e LILACS, de 1992 a agosto 2011, considerando artigos publicados em língua inglesa e portuguesa. Foram utilizadas associações das seguintes expressões: mental disease, child, adolescent, treatment, atypical antipsychotic, aggressive behaviour, aggression e violent behavior. Resultados: Foram identificados 67 artigos de boa qualidade metodológica, de relevância e interesse clínico para o tema em foco. De modo geral, os estudos são relativamente limitados para esta faixa etária, resultado do fato de poucos APAs terem sido aprovados pela Food and Drug Administration (FDA). Dentre as medicações consideradas nesta revisão (risperidona, olanzapina, quetiapina, ziprazidona, aripiprazol e clozapina), todas elas podem ter alguma efetividade no tratamento da agressividade em crianças e adolescentes, ficando a escolha baseada na indicação clínica e perfil de efeitos colaterais. Conclusão: O número ainda limitado de estudos acerca da efetividade e segurança na população pediátrica demanda pesquisas futuras com grupos maiores de pacientes e com mais categorias diagnósticas (como, por exemplo, as formas graves de transtorno de conduta e transtorno desafiador de oposição), desenhadas de forma randomizada e controlada. Assim poderão ser confirmados os achados até o momento e o impacto do uso em lo...

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“…one patient had a probable convulsive crisis in the fourth week and also discontinued the study. Agitation, increased appetite and weight gain were the principal side effects 27 .…”

Section: Discussionmentioning

confidence: 99%

Control of psychomotor agitation and aggressive behavior in patients with autistic disorder: a retrospective chart review

Novaes¹,

Pondé²,

Freire

2008

Arq. Neuro-Psiquiatr.

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-Objective:To evaluate the efficacy of pharmacotherapy on the symptoms of psychomotor agitation and aggressive behavior in a sample of patients with autistic spectrum disorder. Method: The charts of all patients with a diagnosis of autistic spectrum disorder, receiving care for psychomotor agitation and/or aggressive behavior in two psychiatric outpatient departments between 2001 and 2006, were reviewed. The Clinical Global Impression-Severity and -Improvement scales (CGI-S and CGI-I) were applied to the data retrieved from the charts. Results: The majority of the 26 patients included were treated with second-generation antipsychotics. A positive, statistically significant correlation was found between the implementation of pharmacotherapy and a reduction in CGI-S scores (p<0.05). Treatment response in patients with no mental retardation was better than in those mentally retarded (p<0.05). The majority of patients in whom clinical improvement was found following implementation of treatment had participated in at least one form of intervention therapy in addition to the principal treatment (p<0.05). Conclusion: Secondgeneration antipsychotics seem to reduce psychomotor agitation and aggressive behavior in patients with autistic spectrum disorder; however, further studies are required to evaluate the side effects of these drugs in relation to their beneficial effects.Key wordS: antipsychotics, pharmacological, retrospective, autistic disorder, treatment. Controle da agitação psicomotora e agressividade em pacientes com autismo: estudo retrospectivo de revisão de prontuárioResumo -Objetivo: Avaliar a eficácia do tratamento farmacológico dos sintomas de agitação psicomotora e agressividade em amostra de pacientes com transtorno do espectro autista. Método: Foram revisados os prontuários de pacientes com diagnóstico de transtorno do espectro autista que procuraram atendimento por apresentarem agitação psicomotora e/ou heteroagressividade, atendidos entre 2001 e 2006, em dois ambulatórios de psiquiatria. Para avaliação da evolução dos pacientes aplicou-se às informações do prontuário a escala de Impressão Clínica Global Sintomas (ICG-S) e a Impressão Clínica Global Melhora (ICG-M). Resultados: A maioria dos 26 pacientes estava em tratamento com antipsicóticos de segunda geração. Houve correlação positiva e estatisticamente significativa entre a introdução do tratamento farmacológico e a redução nos escores da ICG-S (p<0,05). A evolução do tratamento farmacológico foi melhor para os pacientes sem retardo mental do que para aqueles com retardo mental (p<0,05). A maioria dos pacientes que obteve melhora clínica com o tratamento participava de ao menos uma intervenção auxiliar ao tratamento principal (p<0,05). Conclusão: os antipsicóticos de segunda geração parecem reduzir a agitação psicomotora e agressividade em pacientes com transtorno do espectro autista no Brasil. É necessário que se avaliem os efeitos colaterais em relação aos efeitos benéficos dessas drogas.

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Open-Label Quetiapine in the Treatment of Children and Adolescents with Autistic Disorder

Abstract: Quetiapine was poorly tolerated and associated with serious side effects in this clinical population.

Cited by 154 publications

References 7 publications

Antipsychotic drug-induced weight gain: development of an animal model

Antipsychotic drug-induced weight gain: development of an animal model

Atypical antipsychotics in the treatment of pathological aggression in children and adolescents: literature review and clinical recommendations

Control of psychomotor agitation and aggressive behavior in patients with autistic disorder: a retrospective chart review

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