Metabolic and hormonal side effects in children and adolescents treated with second-generation antipsychotics.
OBJECTIVE
The aim of this study was to evaluate metabolic and hormonal side effects in children and adolescents after 6 months of treatment with 3 different second-generation antipsychotics (SGAs).


METHODS
66 children and adolescents (44 male [66.7%], mean +/- SD age = 15.2 +/- 2.9 years) treated for 6 months with risperidone (N = 22), olanzapine (N = 20), or quetiapine (N = 24) composed the study sample. 34 patients (51.5%) suffered from schizophrenia or other psychosis (according to DSM-IV criteria). Patients were consecutively attending different programs from March 2005 to October 2006. Prior to enrollment in the study, patients were either antipsychotic-naive (37.9%, N = 25) or had been taking an antipsychotic drug for fewer than 30 days. Significant weight gain was defined as a > or = 0.5 increase in body mass index (BMI) z score (adjusted for age and gender) at 6 months. Based on recent criteria for pediatric populations, patients were considered "at risk for adverse health outcome" if they met at least 1 of the following criteria: (1) > or = 85th BMI percentile plus presence of 1 or more negative weight-related clinical outcomes, or (2) > or = 95th BMI percentile.


RESULTS
After the 6 months, BMI z scores increased significantly in patients receiving olanzapine and risperidone. At the 6-month follow-up, 33 patients (50.0%) showed significant weight gain. The number of patients at risk for adverse health outcome increased from 11 (16.7%) to 25 (37.9%) (p = .018). The latter increase was significant only in the olanzapine group (p = .012). Total cholesterol levels increased significantly in patients receiving olanzapine (p = .047) and quetiapine (p = .016). Treatment with quetiapine was associated with a significant decrease in free thyroxin (p = .011).


CONCLUSIONS
Metabolic and hormonal side effects of SGAs in children and adolescents should be carefully monitored when prescribing these drugs.
Fraguas
David
D
Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain. davidfraguas@hggm.es
Merchán-Naranjo
Jessica
J
Laita
Paula
P
Parellada
Mara
M
Moreno
Dolores
D
Ruiz-Sancho
Ana
A
Cifuentes
Alicia
A
Giráldez
Marisa
M
Arango
Celso
C
D000293:Adolescent; D001569:Benzodiazepines / Q000009:adverse effects* / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002648:Child; D039721:Diagnostic and Statistical Manual of Mental Disorders; D003987:Dibenzothiazepines / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009765:Obesity / Q000139:chemically induced* / Q000453:epidemiology*; D000077152:Olanzapine; D015995:Prevalence; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D000069348:Quetiapine Fumarate; D018967:Risperidone / Q000009:adverse effects* / Q000627:therapeutic use; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D019966:Substance-Related Disorders / Q000453:epidemiology; D013974:Thyroxine / Q000172:deficiency; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D003987:Dibenzothiazepines; D014280:Triglycerides; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; D018967:Risperidone; D000077152:Olanzapine; D013974:Thyroxine