title: The safety of olanzapine in young children: a systematic review and meta-analysis.
abstract: BACKGROUND
  Olanzapine is frequently prescribed in young children for psychiatric conditions. It may be an option for chemotherapy-induced nausea and vomiting (CINV) control in children. The objective of this review was to describe the safety of olanzapine in children less than 13 years of age to determine if safety concerns would be a barrier to its use for CINV prevention.
  
  
  METHODS
  Electronic searches were performed in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science and Scopus. All studies in English reporting adverse effects associated with olanzapine use in children younger than 13 years or with a mean/median age less than 13 years were included. Adverse outcomes were synthesized for prospective studies.
  
  
  RESULTS
  A total of 47 studies (17 prospective) involving 387 children aged 0.6-18 years were included; nine described olanzapine poisonings. Weight gain or sedation were reported in 78 % [95 % confidence interval (CI) 63-95] and 48 % (95 % CI 35-67), respectively. Extrapyramidal symptoms or electrocardiogram abnormalities were reported in 9 % (95 % CI 4-21) and 14 % (95 % CI 7-26), respectively. Elevation in liver function tests or blood glucose abnormalities were reported in 7 % (95 % CI 2-20) and 4 % (95 % CI 1-17), respectively. No deaths were attributed to olanzapine.
  
  
  CONCLUSIONS
  No studies were identified with a primary focus on evaluating safety, and the adverse effects reported in the included studies were heterogeneous.
  
  
  CONCLUSIONS
  Most adverse events associated with olanzapine use in children less than 13 years of age are of minor clinical significance. These findings support the exploration of olanzapine for the prevention of CINV in children in future trials.
authors.affiliation: Department of Pharmaceutical Sciences and Department of Pharmacy, Leslie Dan Faculty of Pharmacy, University of Toronto and The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada, jacqueline.flank@sickkids.ca.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Flank
authors.forename: Lillian
authors.initials: L
authors.lastname: Sung
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Dvorak
authors.forename: Wendy
authors.initials: W
authors.lastname: Spettigue
authors.forename: L Lee
authors.initials: LL
authors.lastname: Dupuis
mesh_terms: D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000506:poisoning; D001066:Appetite / Q000187:drug effects; D001569:Benzodiazepines / Q000009:adverse effects* / Q000506:poisoning; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D009325:Nausea / Q000188:drug therapy / Q000517:prevention & control; D000077152:Olanzapine; D014839:Vomiting / Q000188:drug therapy / Q000517:prevention & control; D015430:Weight Gain / Q000187:drug effects
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000077152:Olanzapine