Modifying the risk of atypical antipsychotics in the treatment of juvenile-onset schizophrenia.
BACKGROUND
This review summarizes the evidence for use of typical and atypical antipsychotic medications for the treatment of juvenile-onset schizophrenia. We highlight the risks and benefits of antipsychotic agents for youth with this disorder, paying special attention to weight gain and metabolic effects, an area of specific concern within child and adolescent psychiatry.


METHODS
We describe the seriousness of juvenile-onset schizophrenia and its impact on long-term functioning, noting that pharmacological treatment remains the standard of care for this disorder. We focus on weight gain and metabolic effects associated with atypical agents and review strategies to modify risks associated with these agents.


RESULTS
We summarize strategies for attenuating the risk of weight gain for youth on atypical antipsychotics, including what is known about nutritional counseling and exercise programs as well as pharmacotherapy with adjunctive weight loss agents.


CONCLUSIONS
Given the negative consequences associated with untreated schizophrenia, it appears that the most effective way to improve the risk:benefit ratio in the treatment of adolescents with schizophrenia is to reduce the risks associated with pharmacological treatment.
Townsend
Lisa
L
Rutgers University School of Social Work, Center for Education and Research on Mental Health Therapeutics, 536 George Street, New Brunswick, NJ 08901, USA.
Findling
Robert L
RL
D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015195:Drug Design; D006801:Humans; D011569:Psychiatric Status Rating Scales; D018570:Risk Assessment; D012307:Risk Factors; D012559:Schizophrenia / Q000139:chemically induced* / Q000188:drug therapy; D015430:Weight Gain
D014150:Antipsychotic Agents