title: Update on the safety of second generation antipsychotics in youths: a call for collaboration among paediatricians and child psychiatrists.
abstract: During the past decade, a substantial increase in the use of second generation antipsychotics (SGAs) has occurred for a number of juvenile psychiatric disorders, often as off-label prescriptions. Although they were thought to be safer than older, first generation antipsychotics, mainly due to a lower risk of neurological adverse reactions, recent studies have raised significant concerns regarding their safety regarding metabolic, endocrinological and cardiovascular side effects. Aim of this paper is to update with a narrative review, the latest findings on safety of SGAs in youths. Results suggest that different SGAs may present different safety profiles. Metabolic adverse events are the most frequent and troublesome, with increasing evidences of heightened risk for type II diabetes mellitus. Results are discussed with specific emphasis on possible strategies of an active monitoring, which could enable both paediatricians and child psychiatrists to a possible prevention, early detection, and a timely management of such effects.
authors.affiliation: Department of Mental and Physical Health and Preventive Medicine, Child and Adolescent Neuropsychiatry Division, Second University of Naples, 80131, Naples, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Pisano
authors.affiliation: Department of Mental and Physical Health and Preventive Medicine, Child and Adolescent Neuropsychiatry Division, Second University of Naples, 80131, Naples, Italy.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Catone
authors.affiliation: Child Neurology and Psychiatry Unit, Center for Rare Diseases, Department of Pediatrics, Catholic University, Rome, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Veltri
authors.affiliation: Department of Mental and Physical Health and Preventive Medicine, Child and Adolescent Neuropsychiatry Division, Second University of Naples, 80131, Naples, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Lanzara
authors.affiliation: Scientific Institute IRCCS Eugenio Medea, 23842 Bosisio Parini, Lecco, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Pozzi
authors.affiliation: Unit of Clinical Pharmacology, CNR Institute of Neuroscience, Department of Biomedical and Clinical Sciences, L. Sacco University Hospital, Università di Milano, 20157, Milan, Italy.
authors.forename: Emilio
authors.initials: E
authors.lastname: Clementi
authors.affiliation: Department of Pediatrics, Hospital "F. Veneziale", Isernia, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Iuliano
authors.affiliation: Department of Mental and Physical Health and Preventive Medicine, Child and Adolescent Neuropsychiatry Division, Second University of Naples, 80131, Naples, Italy.
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Riccio
authors.affiliation: Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences L Sacco, L. Sacco University Hospital, Università di Milano, 20157, Milan, Italy.|Faculty of Education Science, University Suor Orsola Benincasa of Naples, Naples, Italy.
authors.forename: Sonia
authors.initials: S
authors.lastname: Radice
authors.affiliation: Scientific Institute IRCCS Eugenio Medea, 23842 Bosisio Parini, Lecco, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Molteni
authors.affiliation: Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Department of Experimental Medicine, Second University of Naples, 80131, Naples, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Capuano
authors.affiliation: Child Neuropsychiatry, Faculty of Education, Suor Orsola Benincasa University, Naples, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Gritti
authors.affiliation: Clinic of Child and Adolescent Neuropsychiatry, Department of Medicine and Surgery, S. Giovanni di Dio and Ruggi d'Aragona Hospital, University of Salerno, Fisciano, Italy.
authors.forename: Giangennaro
authors.initials: G
authors.lastname: Coppola
authors.affiliation: IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy.
authors.forename: Annarita
authors.initials: A
authors.lastname: Milone
authors.affiliation: Department of Translational Medical Sciences, University Federico II of Naples, Via Pansini 5, 80131, Naples, Italy. carmela.bravaccio@unina.it.
authors.forename: Carmela
authors.initials: C
authors.lastname: Bravaccio
authors.affiliation: IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Masi
mesh_terms: D000293:Adolescent; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001480:Basal Ganglia Diseases / Q000139:chemically induced; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced; D016903:Drug Monitoring; D050171:Dyslipidemias / Q000139:chemically induced; D006801:Humans; D008133:Long QT Syndrome / Q000139:chemically induced; D056687:Off-Label Use; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D015430:Weight Gain
chemical_list: D014150:Antipsychotic Agents
keywords: Adolescents; Adverse events; Antipsychotics; Children