title: Antipsychotics in children and adolescents with schizophrenia: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To systematically review the efficacy and tolerability data of antipsychotics in children and adolescents with schizophrenia.
  
  
  METHODS
  Pubmed, Google scholar and Psych Info were searched to identify studies published in peer-reviewed English language journals. All studies evaluating the efficacy of antipsychotics in children and adolescents with schizophrenia and having 3 or more participants were included. Of the studies identified, only randomized controlled trials were included in the meta-analysis. Data was analysed using effect size calculation as per Cohen's d. Fifty published studies were identified which reported use of antipsychotics in children and adolescents with schizophrenia. Of these, 15 randomized controlled studies were included in meta-analysis.
  
  
  RESULTS
  Evidence suggests that both first generation antipsychotics (FGA) and second generation antipsychotics (SGAs) are better than placebo (effect size [ES] 2.948, confidence interval [CI] 1.368 to 4.528, sample size 31; and ES 0.454, CI 0.414 to 0.542, sample size 1308 respectively). However, FGAs seemed to be inferior to SGAs (ES -0.363, CI -0.562 to -0.163, sample size of 243) and clozapine is superior to all other antipsychotics (ES 0.848, CI 0.748 to 0.948, and sample size 85) in treatment of schizophrenia in children and adolescents. The extrapyramidal side effects are more common with FGAs while metabolic adverse effects are more common with SGAs.
  
  
  CONCLUSIONS
  FGAs and SGAs are effective in the treatment of children and adolescents with schizophrenia. Clozapine apparently is the most effective antipsychotic in this condition.
authors.affiliation: Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Siddharth
authors.initials: S
authors.lastname: Sarkar
authors.forename: Sandeep
authors.initials: S
authors.lastname: Grover
mesh_terms: D000293:Adolescent; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D006801:Humans; D010919:Placebos; D016032:Randomized Controlled Trials as Topic; D012559:Schizophrenia / Q000188:drug therapy*
chemical_list: D014150:Antipsychotic Agents; D010919:Placebos
keywords: Adolescents; antipsychotics; children; schizophrenia