Recognizing and Monitoring Adverse Events of Second-Generation Antipsychotics in Children and Adolescents

Correll, Christoph U.; Penzner, Julie B.; Parikh, Umesh H.; Mughal, Tahir; Javed, Tariq; Carbon, Maren; Malhotra, Anil K.

doi:10.1016/j.chc.2005.08.007

Cited by 163 publications

(160 citation statements)

References 172 publications

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“…28 Although the occurrence of EPS due to the use of AAP among young patients is not negligible, it is less frequent than that of TAP. 29 In studies designed to investigate schizophrenia starting in childhood, among AAPs, clozapine and quetiapine have been associated with lower rates of EPS, similarly to what is observed among adults. 30,31 According to the Treatment Recommendations for the Use of Antipsychotics for Aggressive Youth (TRAAY), based on studies available and specialist consensus, treatment should begin with low doses that are then increased gradually, and its efficacy should be evaluated at the most two weeks later.…”

Section: Resultsmentioning

confidence: 99%

“…55,57,65 However, only longitudinal prospective studies will be able to demonstrate the real impact of AAP on this population, particularly in terms of metabolic and hormone changes 1,26 associated with growth and development, although adverse events are well tolerated and manageable. [27][28][29]66 Studies that analyzed metabolic changes, such as weight gain, dyslipidemia and the risk of diabetes, have recommended that these medications should be used carefully, and that a proactive attitude should be adopted, with systematic monitoring using laboratory tests, weight control and nutritional interventions. 13,14,29,32 Studies about the treatment of pathological aggression, particularly severe or extreme forms of it, in children and adolescents, remain limited.…”

Section: Discussionmentioning

confidence: 99%

“…[27][28][29]66 Studies that analyzed metabolic changes, such as weight gain, dyslipidemia and the risk of diabetes, have recommended that these medications should be used carefully, and that a proactive attitude should be adopted, with systematic monitoring using laboratory tests, weight control and nutritional interventions. 13,14,29,32 Studies about the treatment of pathological aggression, particularly severe or extreme forms of it, in children and adolescents, remain limited. Therefore, there are no solid scientific bases for clinical decisions at a higher degree of safety.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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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“…For olanzapine, we have been able to locate only studies assessing adult first episode patients for 12 weeks with 6-7.3 kg weight gain [24,34], and up to 4 months with 7.7 kg weight gain [34]. Weight gain and metabolic changes have been described in this population [4,5]. However, the weight gain in the present study is greater than that seen in more chronic pediatric patients [9,29,37,38] that may have already gained weight due to antipsychotic treatment prior to study entry.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, there is very limited efficacy or safety evidence from randomized controlled trials to support these prescribing trends in children and adolescents with psychotic symptoms [5]. In fact, there have been more studies with SGA for the treatment of disruptive behaviors and developmental disorders than in patients with psychotic symptoms [8].…”

Section: Introductionmentioning

confidence: 99%

Olanzapine compared to quetiapine in adolescents with a first psychotic episode

Arango

Robles

Parellada

et al. 2009

Eur Child Adolesc Psychiatry

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Objective: To compare the efficacy, safety, and tolerability of olanzapine and quetiapine in adolescents with first episode psychosis. Method: Fifty adolescents (age 16 ± 1.25) with a first episode of psychosis were randomized to quetiapine or olanzapine in a 6-month open label study. Efficacy and side effect scales, as well as vital signs and laboratory data were recorded at baseline, 7, 15, 30, 90, and 180 days (end of study). Results: Out of the total sample included in the study, 32 patients completed the trial (quetiapine n = 16, olanzapine n = 16). Patients in both treatment groups had a significant reduction in all clinical scales with the exception of the negative scale of the Positive and Negative Symptom Scale (PANSS) for olanzapine and the general psychopathology scale of the PANSS for quetiapine. The only difference between treatment arms on the clinical scales was observed on the patients' strength and difficulties questionnaire (SDQ) scale, with greater improvement for olanzapine. Patients on olanzapine gained 15.5 kg and patients on quetiapine gained 5.5 kg. Conclusion: Olanzapine and quetiapine reduced psychotic symptoms in this adolescent sample. Patients on olanzapine gained significantly more weight. Side effects with both drugs seemed to be more prevalent than those reported in adult studies

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

McIntyre

Jerrell²

2008

Arch Pediatr Adolesc Med

158

113

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Recognizing and Monitoring Adverse Events of Second-Generation Antipsychotics in Children and Adolescents

Cited by 163 publications

References 172 publications

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

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

Olanzapine compared to quetiapine in adolescents with a first psychotic episode

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

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