title: Second-generation antipsychotic use in children and adolescents: a six-month prospective cohort study in drug-naïve patients.
abstract: OBJECTIVE
  To assess weight and metabolic effects of 6 months of treatment with second-generation antipsychotics in naïve/quasi-naïve youths.
  
  
  METHODS
  This study looked at a nonrandomized, naturalistic, multicenter, inception cohort study of 279 patients aged 4 to 17 years (mean = 14.6 ± 2.9 years). Of those, 248 (88.8%) received a single antipsychotic (risperidone, olanzapine, or quetiapine) and completed 2 visits, and 178 (63.8%) completed the 6-month follow-up. Patients had schizophrenia-spectrum disorders (44.5%), mood-spectrum disorders (23.2%), disruptive behavioral disorders (17.3%), or other disorders (15.1%). Fifteen age- and gender-matched, healthy, nonmedicated individuals served as a comparison group.
  
  
  RESULTS
  From baseline to 1 month, 3 months, and 6 months, all anthropometric measures increased significantly with each antipsychotic, that is, 6-month changes with risperidone (n = 157; 7.1 kg and 0.66 body mass index [BMI] z score), olanzapine (n = 44; 11.5 kg and 1.08 BMI z score), and quetiapine (n = 47; 6.3 kg and 0.54 BMI z score), but not in healthy control participants (-0.11 kg and 0.006 BMI z score). Fasting metabolic parameters increased significantly with risperidone (glucose [3.8] mg/dL, insulin [4.9] mU/L, homeostasis model assessment of insulin resistance [HOMA-IR: 1.2], triglycerides [15.6] mg/dL), and olanzapine (glucose [5.0] mg/dL, total cholesterol [21.2] mg/dL, and low-density lipoprotein cholesterol [44.6] mg/dL), but not with quetiapine or in healthy control participants. The percentage of research participants considered to be "at risk of adverse health outcome" increased during the 6 months from 8.9% to 29.2% for risperidone (p < .0001), 6.8% to 38.1% for olanzapine (p < .0001), and 6.3% to 4.0% for quetiapine (p = .91).
  
  
  CONCLUSIONS
  Olanzapine, quetiapine, and risperidone increase body weight but have different cardiometabolic side effect profiles and different temporal side effect patterns.
authors.affiliation: Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, and Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Madrid. Electronic address: carango@hggm.es.
authors.forename: Celso
authors.initials: C
authors.lastname: Arango
authors.affiliation: Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, and Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Madrid.
authors.forename: Miriam
authors.initials: M
authors.lastname: Giráldez
authors.affiliation: Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, and Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Madrid.
authors.forename: Jessica
authors.initials: J
authors.lastname: Merchán-Naranjo
authors.affiliation: Institut Clínic de Neurociènces, Hospital Clínic, Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), SGR-1119, University of Barcelona, and CIBERSAM.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Baeza
authors.affiliation: Institut Clínic de Neurociènces, Hospital Clínic, Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), SGR-1119, University of Barcelona, and CIBERSAM.
authors.forename: Josefina
authors.initials: J
authors.lastname: Castro-Fornieles
authors.affiliation: Hospital Sant Joan de Déu and CIBERSAM.
authors.forename: Jose-Angel
authors.initials: JA
authors.lastname: Alda
authors.affiliation: Hospital Universitario Niño Jesús, Madrid.
authors.forename: Carmen
authors.initials: C
authors.lastname: Martínez-Cantarero
authors.affiliation: Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, and Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Madrid.
authors.forename: Carmen
authors.initials: C
authors.lastname: Moreno
authors.affiliation: Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, and Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Madrid.
authors.forename: Pilar
authors.initials: P
authors.lastname: de Andrés
authors.affiliation: Hospital General Universitario Gregorio Marañón.
authors.forename: Cristina
authors.initials: C
authors.lastname: Cuerda
authors.affiliation: Institut Clínic de Neurociènces, Hospital Clínic, Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), SGR-1119, University of Barcelona, and CIBERSAM.
authors.forename: Elena
authors.initials: E
authors.lastname: de la Serna
authors.affiliation: Zucker Hillside Hospital, Psychiatry Research, North Shore-Long Island Jewish Health System, Glen Oaks, NY and Hofstra-North Shore Long Island Jewish School of Medicine, Hempstead, NY.
authors.forename: Christoph U
authors.initials: CU
authors.lastname: Correll
authors.affiliation: Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, and Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Madrid.
authors.forename: David
authors.initials: D
authors.lastname: Fraguas
authors.affiliation: Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, and Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Madrid.
authors.forename: Mara
authors.initials: M
authors.lastname: Parellada
mesh_terms: D000293:Adolescent; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003987:Dibenzothiazepines / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D000077152:Olanzapine; D011379:Prognosis; D011446:Prospective Studies; D000069348:Quetiapine Fumarate; D012307:Risk Factors; D018967:Risperidone / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; D018967:Risperidone; D000077152:Olanzapine
keywords: metabolic syndrome; olanzapine; quetiapine; risperidone; youth