Paediatric uses of atypical antipsychotics

Abstract

Antipsychotics are commonly prescribed to children and adolescents. With the relatively recent availability of the atypical antipsychotics, physicians have begun prescribing these agents to young people in the hope of finding safe, effective alternatives to the typical antipsychotics. This report reviews what is currently known about the use of the atypical antipsychotics in young people. Most of the currently available data are based on case reports and case series. The results of only a handful of prospective trials pertaining to the use of the atypical antipsychotics in youths have been reported. Based on the available information, it appears that clozapine has a role in juvenile treatment resistant schizophrenia. When considered as a group, the 'first-line' atypical antipsychotics risperidone, olanzapine and quetiapine appear to have promise as treatments for several neuropsychiatric disorders in young people. These conditions include psychotic, mood, disruptive, movement and pervasive developmental disorders. Unfortunately, as has historically been the case, the demand to address the clinical needs of young patients with neuropsychiatric disorders has outpaced empirically based information. This is particularly important because significant side effects can occur when children or adolescents are treated with atypical antipsychotics. Since there is a paucity of short-term and almost no long-term safety data pertaining to these agents in young people, careful consideration must be made prior to initiating atypical antipsychotic treatment for a child or teenager. Based upon what is known about these agents, a rational approach to the use of these drugs in juveniles is offered.

Combined dyslipidemia in childhood

“…These medications are being commonly and increasingly prescribed in the pediatric age group. 27 Among these drugs, several are known to be associated with sudden and severe weight gain and with significant increases in TGs and TC and reductions in HDL-C. 28 Taken together, these findings suggest that CD may become even more prevalent in the future.…”

Current issues in child and adolescent psychopharmacology. Part 2: Anxiety and obsessive—compulsive disorders, autism, Tourette's and schizophrenia

“…The atypicals, particularly risperidone, have been shown to reduce aggression in patients with dementia and schizophrenia and in children with learning disabilities and conduct disorder (e.g. Findling et al, 2000). As aggression is a common problem in autism, it is hoped that similar effects will be seen in this group of patients.…”

Antipsychotic Medication in Children and Adolescents: A Descriptive Review of the Effects on Prolactin Level and Associated Side Effects

“…In particular, low dosages of risperidone and olanzapine appear to be effective in the treatment of behavioral problems in autism spectrum disorders (Malone et al 2002;McCracken et al 2002), conduct disorders (Findling et al 2000;Aman et al 2002;Snyder et al 2002), and acute psychotic symptoms (Arango et al 2004;Sikich et al 2004). However, risperidone and olanzapine may have potential long-term side effects.…”