title: Increased Risk of Obesity and Metabolic Dysregulation Following 12 Months of Second-Generation Antipsychotic Treatment in Children: A Prospective Cohort Study.
abstract: OBJECTIVE
  To determine the risk of developing obesity and related metabolic complications in children following long-term treatment with risperidone or quetiapine.
  
  
  METHODS
  This was a 1-year naturalistic longitudinal study conducted between February 2009 and March 2012. A total of 130 children aged 2 to 18 years without prior exposure to second-generation antipsychotics (SGAs) were enrolled at initiation of treatment with either risperidone or quetiapine. Metabolic parameters were measured at baseline and months 6 and 12. Data of 37 participants (20 treated with risperidone and 17 treated with quetiapine) who completed 12-month monitoring were used in the analysis.
  
  
  RESULTS
  After 1 year of SGA treatment, mean weight increased significantly by 10.8 kg (95% CI 7.9 kg to 13.7 kg) for risperidone and 9.7 kg (95% CI 6.5 kg to 12.8 kg) for quetiapine. Body mass index z score also increased significantly in both groups (P < 0.001). There was a high incidence of children becoming overweight or obese (6/15 [40.0%] for risperidone-treated and 7/14 [50.0%] for quetiapine-treated). The mean levels of fasting glucose (for risperidone-treated) and ratio of total cholesterol to high-density lipoprotein cholesterol (for quetiapine-treated) increased significantly by 0.23 mmol/L (95% CI 0.03 mmol/L to 0.42 mmol/L) and 0.48 mmol/L (95% CI 0.15 mmol/L to 0.80 mmol/L), respectively.
  
  
  CONCLUSIONS
  Children treated with risperidone or quetiapine are at a significant risk for developing obesity, elevated waist circumference, and dyslipidemia during 12 months of treatment. These data emphasize the importance of regular monitoring for early identification and treatment of metabolic side effects.
authors.affiliation: Pediatrics Resident, Department of Pediatrics, University of British Columbia, British Columbia Children's Hospital, Vancouver, British Columbia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ronsley
authors.affiliation: Research Coordinator and Statistical Analyst, Department of Pediatrics, University of British Columbia, British Columbia Children's Hospital, Vancouver, British Columbia.
authors.forename: Duc
authors.initials: D
authors.lastname: Nguyen
authors.affiliation: Vice President Medical Affairs and Psychiatrist in Chief, Children's and Women's Mental Health and Substance Use Programs, British Columbia Children's Hospital, Vancouver, British Columbia; Clinical Professor, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia.
authors.forename: Jana
authors.initials: J
authors.lastname: Davidson
authors.affiliation: Pediatric Endocrinologist, British Columbia Children's Hospital, Vancouver, British Columbia; Clinical Professor, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia.
authors.forename: Constadina
authors.initials: C
authors.lastname: Panagiotopoulos
mesh_terms: D000293:Adolescent; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000188:drug therapy; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000188:drug therapy; D001794:Blood Pressure; D015992:Body Mass Index; D001955:British Columbia / Q000453:epidemiology; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000188:drug therapy; D002675:Child, Preschool; D002784:Cholesterol / Q000378:metabolism; D008076:Cholesterol, HDL / Q000378:metabolism; D015331:Cohort Studies; D050171:Dyslipidemias / Q000453:epidemiology* / Q000378:metabolism; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy*; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000378:metabolism; D019964:Mood Disorders / Q000188:drug therapy; D009765:Obesity / Q000453:epidemiology* / Q000378:metabolism; D050177:Overweight / Q000453:epidemiology / Q000378:metabolism; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000188:drug therapy; D000069348:Quetiapine Fumarate / Q000627:therapeutic use*; D012307:Risk Factors; D018967:Risperidone / Q000627:therapeutic use*; D055105:Waist Circumference
chemical_list: D014150:Antipsychotic Agents; D008076:Cholesterol, HDL; D000069348:Quetiapine Fumarate; D002784:Cholesterol; D018967:Risperidone