Some of the most effective treatments for autism spectrum disorder (ASD) are also well known for their risk of weight gain and subsequent health complications. For the first time, however, researchers have compared five of these second generation antipsychotics (SGAs) to determine which ones are the biggest culprits.
The Cincinnati Children's Hospital Medical Center study found that patients treated with Zyprexa® (olanzapine) have the highest risk of weight gain, while Geodon (ziprasidone®) and Seroquel (quetiapine) were not associated with an increase in body mass index.
Risperdal® (risperidone) and Abilify® (aripiprazole) also resulted in weight gain, but not as great as the weight gain associated with Zyprexa® (olanzapine).
"Caregivers treating children and teens with ASD, and parents, can use this information to balance the risks and benefits of SGAs for treating irritability associated with autism spectrum disorders," says Logan Wink, MD, a research psychiatrist at Cincinnati Children's and co-author of the study.
The study is published online in the Journal of Child and Adolescent Psychopharmacology.
ASD is often associated with irritability, including aggression, self-injury and severe behavioral outbursts, all of which can cause significant distress to patients, their families, schools and others. The FDA has approved several SGAs in recent years, as this class of medications has proved to be safe and often effective. Unfortunately, health concerns, such as changes in glucose and lipid metabolism and poor cardiovascular outcomes have been among the side effects of some of these medications.
The Cincinnati Children's researchers reviewed medical charts of 202 patients between the ages of 2 and 20 treated at two large subspecialty clinics. These patients were treated with one of the five SGAs studied for a maximum of four years.
"Given that this was a chart review, our results must be considered along with its limitations," says Dr. Wink. "We believe, however, that this study adds to the growing safety data regarding use of SGAs and lays the ground work for future controlled head-to-head analysis of SGA treatment in ASD patients."
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