Endocrine and metabolic adverse effects of psychotropic medications in children and adolescents.
OBJECTIVE
Despite increasing use of psychotropic medications in children and adolescents, data regarding their efficacy and safety are limited. Endocrine and metabolic adverse effects are among the most concerning adverse effects of commonly used psychotropic medications.


METHODS
Selective review of endocrine and metabolic effects of psychotropic medications in pediatric populations, with a focus on monitoring and management strategies.


RESULTS
Because youth are still developing at the time of psychotropic drug exposure, most reference values need to be adjusted for gender and age. As in adults, youngsters receiving lithium require monitoring for thyroid dysfunction. Psychostimulants appear to cause mild reversible growth retardation in some patients, most likely because of decreased weight or slowing of expected weight gain; some patients may experience clinically significant reductions in adult height. Although still controversial, valproate use has been associated with an increased risk for polycystic ovary syndrome, in addition to causing weight gain. Although more data are required, children and adolescents appear to be at higher risk than adults for antipsychotic-induced hyperprolactinemia, weight gain, and possibly, associated metabolic abnormalities, which is of particular concern.


CONCLUSIONS
Clinicians and caregivers need to be aware of potential endocrine and metabolic adverse effects of psychiatric medications. A careful selection of patients, choice of agents with potentially lesser risk for these adverse events, healthy lifestyle counseling, as well as close health monitoring are warranted to maximize effectiveness and safety.
Correll
Christoph U
CU
The Zucker Hillside Hospital, Psychiatry Research, 75-59 263rd Street, Glen Oaks, NY 11004, USA. ccorrell@lij.edu
Carlson
Harold E
HE
D000293:Adolescent; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D003987:Dibenzothiazepines / Q000008:administration & dosage / Q000009:adverse effects*; D004334:Drug Administration Schedule; D004700:Endocrine System Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000209:etiology; D008019:Life Style; D018020:Lithium Compounds / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008659:Metabolic Diseases / Q000209:etiology*; D011085:Polycystic Ovary Syndrome / Q000209:etiology; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000523:psychology; D000069348:Quetiapine Fumarate; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D014635:Valproic Acid / Q000008:administration & dosage / Q000009:adverse effects*; D015430:Weight Gain / Q000187:drug effects
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D018020:Lithium Compounds; D000069348:Quetiapine Fumarate; D017367:Selective Serotonin Reuptake Inhibitors; D014635:Valproic Acid