Featured Research

from universities, journals, and other organizations

Use Of Antipsychotic Medications By Children And Adolescents Associated With Significant Weight Gain

Date:
October 29, 2009
Source:
JAMA and Archives Journals
Summary:
Many pediatric and adolescent patients who received second-generation antipsychotic medications experienced significant weight gain, along with varied adverse effects on cholesterol and triglyceride levels and other metabolic measures, according to a new study.

Many pediatric and adolescent patients who received second-generation antipsychotic medications experienced significant weight gain, along with varied adverse effects on cholesterol and triglyceride levels and other metabolic measures, according to a study in the October 28 issue of JAMA.

Treatment for psychotic disorders, bipolar disorder, and nonpsychotic mental disorders for children and adolescents in the United States often includes second-generation antipsychotic medications. "Increasingly, the cardiometabolic effects of second-generation antipsychotic medications have raised concern. Cardiometabolic adverse effects, such as age-inappropriate weight gain, obesity, hypertension, and lipid and glucose abnormalities, are particularly problematic during development because they predict adult obesity, the metabolic syndrome, cardiovascular morbidity, and malignancy," the authors write. The cardiometabolic effects of these medications have not been sufficiently studied in children and adolescent patients who have not previously received them, according to background information in the article.

Christoph U. Correll, M.D., of Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, New York, and colleagues conducted a study of weight and metabolic changes in a group of 272 pediatric patients (ages 4 to 19 years) who had not previously received antipsychotic medication. Patients had mood spectrum (47.8 percent), schizophrenia spectrum (30.1 percent), and disruptive or aggressive behavior spectrum (22.1 percent) disorders. Fifteen patients who refused participation or were nonadherent to medications served as a comparison group. Patients were treated with the antipsychotic medications aripiprazole, olanzapine, quetiapine, or risperidone for 12 weeks.

After a median (midpoint) of 10.8 weeks of treatment, weight increased by an average of 18.7 lbs. with olanzapine (n = 45), by 13.4 lbs. with quetiapine (n = 36), by 11.7 lbs. with risperidone (n = 135), and by 9.7 lbs. with aripiprazole (n = 41) compared with minimal weight change of 0.4 lbs. in the untreated comparison group (n = 15). "Each antipsychotic medication was associated with significantly increased fat mass and waist circumference," the authors write. "Altogether, 10 percent to 36 percent of patients transitioned to overweight or obese status within 11 weeks."

The researchers also found that adverse changes during the study period reached statistical significance for olanzapine and quetiapine for total cholesterol, triglycerides, non-HDL cholesterol, and ratio of triglycerides to HDL cholesterol. "With risperidone, levels of triglycerides increased significantly. Metabolic baseline-to-end-point changes were not significant with aripiprazole or in the untreated comparison group. Patients receiving quetiapine had modestly higher incidence rates of hyperglycemia and the metabolic syndrome and patients receiving olanzapine experienced the highest incidence rates."

The authors note that these results are concerning because they include fat mass and waist circumference, which are associated with the metabolic syndrome in adults treated with antipsychotic medications and heart disease in the general population. "Moreover, abnormal childhood weight and metabolic status adversely affect adult cardiovascular outcomes via continuation of these risk factors or independent or accelerated mechanisms."

"Our results, together with data from first-episode studies, suggest that guidelines for antipsychotic medication exposure for vulnerable pediatric and adolescent patients naive to antipsychotic medication should consider more frequent (e.g., biannual) cardiometabolic monitoring after the first 3 months of treatment. Finally, in view of poor physical health outcomes and suboptimal metabolic monitoring in the severely mentally ill, the benefits of second-generation antipsychotic medications must be balanced against their cardiometabolic risks through a careful assessment of the indications for their use, consideration of lower-risk alternatives, and proactive adverse effect monitoring and management," the authors conclude.

Editorial: Implications of Marked Weight Gain Associated With Atypical Antipsychotic Medications in Children and Adolescents

Christopher K. Varley, M.D., and Jon McClellan, M.D., of Seattle Children's Hospital, write in an accompanying editorial that these findings indicate there are other factors to consider regarding the use of atypical antipsychotic medications in children and adolescents.

"These medications can be lifesaving for youth with serious psychiatric illnesses such as schizophrenia, classically defined bipolar disorder, or severe aggression associated with autism. However, given the risk for weight gain and long-term risk for cardiovascular and metabolic problems, the widespread and increasing use of atypical antipsychotic medications in children and adolescents should be reconsidered."


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal References:

  1. Christoph U. Correll; Peter Manu; Vladimir Olshanskiy; Barbara Napolitano; John M. Kane; Anil K. Malhotra. Cardiometabolic Risk of Second-Generation Antipsychotic Medications During First-Time Use in Children and Adolescents. JAMA, 2009; 302 (16): 1765-1773 [link]
  2. Christopher K. Varley; Jon McClellan. Implications of Marked Weight Gain Associated With Atypical Antipsychotic Medications in Children and Adolescents. JAMA, 2009; 302 (16): 1811-1812 [link]

Cite This Page:

JAMA and Archives Journals. "Use Of Antipsychotic Medications By Children And Adolescents Associated With Significant Weight Gain." ScienceDaily. ScienceDaily, 29 October 2009. <www.sciencedaily.com/releases/2009/10/091027161526.htm>.
JAMA and Archives Journals. (2009, October 29). Use Of Antipsychotic Medications By Children And Adolescents Associated With Significant Weight Gain. ScienceDaily. Retrieved October 22, 2014 from www.sciencedaily.com/releases/2009/10/091027161526.htm
JAMA and Archives Journals. "Use Of Antipsychotic Medications By Children And Adolescents Associated With Significant Weight Gain." ScienceDaily. www.sciencedaily.com/releases/2009/10/091027161526.htm (accessed October 22, 2014).

Share This



More Health & Medicine News

Wednesday, October 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

CDC Revamps Ebola Guidelines After Criticism

CDC Revamps Ebola Guidelines After Criticism

Newsy (Oct. 21, 2014) The Centers for Disease Control and Prevention have issued new protocols for healthcare workers interacting with Ebola patients. Video provided by Newsy
Powered by NewsLook.com
WHO: Ebola Vaccine Trials to Start a in January

WHO: Ebola Vaccine Trials to Start a in January

AP (Oct. 21, 2014) Tens of thousands of doses of experimental Ebola vaccines could be available for "real-world" testing in West Africa as soon as January as long as they are deemed safe in soon to start trials, the World Health Organization said Tuesday. (Oct. 21) Video provided by AP
Powered by NewsLook.com
First-Of-Its-Kind Treatment Gives Man Ability To Walk Again

First-Of-Its-Kind Treatment Gives Man Ability To Walk Again

Newsy (Oct. 21, 2014) A medical team has for the first time given a man the ability to walk again after transplanting cells from his brain onto his severed spinal cord. Video provided by Newsy
Powered by NewsLook.com
CDC Issues New Ebola Guidelines for Health Workers

CDC Issues New Ebola Guidelines for Health Workers

Reuters - US Online Video (Oct. 21, 2014) The U.S. Centers for Disease Control and Prevention has set up new guidelines for health workers taking care of patients infected with Ebola. Linda So reports. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins