Use and tolerability of newer antipsychotics and antidepressants: a chart review in a paediatric setting.
OBJECTIVE
To analyse the prescribing pattern and the safety profile of different atypical antipsychotics and selective serotonin reuptake inhibitors (SSRIs) during the years 2002-2003 in paediatric setting.


METHODS
Two Child Neurology and Psychiatry Divisions of Southern Italy (University of Messina and "Oasi Institute for Research on Mental Retardation and Brain Aging" of Troina).


METHODS
A retrospective chart review of all children and adolescents starting an incident treatment with atypical antipsychotics or SSRIs was performed. Within the first 3 months of therapy, any potential adverse drug reaction (ADR) was identified and the clinical outcome of psychotropic drug treatment was assessed.


METHODS
Rate of ADR in the first 3 months of therapy with atypical antipsychotics and SSRIs in children and adolescents.


RESULTS
On a total of 97 patients' charts being reviewed, 73 (75%) concerned atypical antipsychotics and 24 (25%) SSRIs. Risperidone (N=45, 62%) was the most frequently prescribed antipsychotic drug, followed by olanzapine (24, 32%). Overall, 50 (68%) antipsychotic users reported a total of 108 ADRs during the first 3 months of therapy, leading to drug discontinuation in 23 patients (31%). Among 24 users of SSRI, 12 (50%) received paroxetine, 6 (25%) sertraline, 5 (21%) citalopram and 1 (4%) fluoxetine. Only paroxetine users (21%) reported at least one ADR, however, none of SSRI users withdrew drug treatment within first 3 months.


CONCLUSIONS
ADRs occurred frequently during first 3 months of treatment with atypical antipsychotics and, to a lesser extent, with SSRIs in children and adolescents. Further investigations are urgently needed to better define the benefit/risk ratio of psychotropic medications in paediatric setting.
Alacqua
Marianna
M
Department of Clinical and Experimental Medicine and Pharmacology, Pharmacology Unit, University of Messina, Via Consolare Valeria-Gazzi, 98125 Messina, Italy. alacqua@unime.it
Trifirò
Gianluca
G
Arcoraci
Vincenzo
V
Germanò
Eva
E
Magazù
Angela
A
Calarese
Tiziana
T
Di Vita
Giuseppa
G
Gagliano
Catalda
C
Spina
Edoardo
E
D000293:Adolescent; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D015283:Citalopram / Q000009:adverse effects / Q000627:therapeutic use; D017723:Drug Utilization Review; D005260:Female; D005473:Fluoxetine / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D006966:Hyperprolactinemia / Q000139:chemically induced*; D007558:Italy; D008297:Male; D008499:Medical Records; D001523:Mental Disorders / Q000188:drug therapy; D000077152:Olanzapine; D017374:Paroxetine / Q000009:adverse effects / Q000627:therapeutic use; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D018967:Risperidone / Q000009:adverse effects / Q000627:therapeutic use; D020280:Sertraline / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome
D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D005473:Fluoxetine; D015283:Citalopram; D001569:Benzodiazepines; D017374:Paroxetine; D018967:Risperidone; D000077152:Olanzapine; D020280:Sertraline