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Weight gain and metabolic risks associated with antipsychotic medications in children and adolescents.
J Child Adolesc Psychopharmacol. 2011 Dec; 21(6):517-35.JC

Abstract

BACKGROUND

Antipsychotic-related weight gain and metabolic adverse effects have become a major focus, especially in youth.

METHODS

Review of randomized, cohort, and pharmacoepidemiologic studies of antipsychotic-related weight gain and metabolic adverse effects and of interventions for their reduction in youth.

RESULTS

Across 34 published head-to-head and placebo-controlled studies in youth with psychotic and bipolar disorders, weight gain ranged from 3.8 to 16.2 kg with olanzapine (n=353), 0.9-9.5 kg with clozapine (n=97), 1.9-7.2 kg with risperidone (n=571), 2.3-6.1 kg with quetiapine (n=133), and 0-4.4 kg with aripiprazole (n=451). In 24 placebo-controlled trials, the numbers-needed-to-harm for weight gain ≥7% in youth with bipolar disorder and schizophrenia were 39 (confidence interval [CI]: -1 to +6, not significant) for aripiprazole, 36 (CI: -1 to +7, not significant) for ziprasidone, 9 (CI: 7-14) for quetiapine, 6 (CI: 5-8) for risperidone, and 3 (CI: 3-4) for olanzapine. Data in youth with autism and disruptive behavior disorders, available only for some antipsychotics, suggest greater weight gain, possibly due to less prior antipsychotic exposure. Three-month results from a large cohort study in antipsychotic-naïve youth indicated that metabolic effects differ among second-generation antipsychotics, despite significant weight gain with all studied agents, suggesting additional, weight-independent effects. Further, pharmacoepidemiologic work indicates that antipsychotic polypharmacy increases the risk for obesity (odds ratio [OR]: 2.28 [CI: 1.49-3.65]) or any cardiovascular, cerebrovascular, or hypertensive adverse event (OR: 1.72 [CI: 1.10-2.69]). However, despite marked weight gain and its greater impact on youth, monitoring rates are low and studies of pharmacologic and behavioral interventions are extremely limited.

CONCLUSIONS

More research is needed to develop strategies to minimize antipsychotic-related weight gain and metabolic effects in youth and to discover treatments with lower risk potential.

Authors+Show Affiliations

Nathan Kline Institute for Psychiatric Research, Orangeburg, New York, USA.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

22166172

Citation

Maayan, Lawrence, and Christoph U. Correll. "Weight Gain and Metabolic Risks Associated With Antipsychotic Medications in Children and Adolescents." Journal of Child and Adolescent Psychopharmacology, vol. 21, no. 6, 2011, pp. 517-35.
Maayan L, Correll CU. Weight gain and metabolic risks associated with antipsychotic medications in children and adolescents. J Child Adolesc Psychopharmacol. 2011;21(6):517-35.
Maayan, L., & Correll, C. U. (2011). Weight gain and metabolic risks associated with antipsychotic medications in children and adolescents. Journal of Child and Adolescent Psychopharmacology, 21(6), 517-35. https://doi.org/10.1089/cap.2011.0015
Maayan L, Correll CU. Weight Gain and Metabolic Risks Associated With Antipsychotic Medications in Children and Adolescents. J Child Adolesc Psychopharmacol. 2011;21(6):517-35. PubMed PMID: 22166172.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Weight gain and metabolic risks associated with antipsychotic medications in children and adolescents. AU - Maayan,Lawrence, AU - Correll,Christoph U, Y1 - 2011/12/13/ PY - 2011/12/15/entrez PY - 2011/12/15/pubmed PY - 2012/4/25/medline SP - 517 EP - 35 JF - Journal of child and adolescent psychopharmacology JO - J Child Adolesc Psychopharmacol VL - 21 IS - 6 N2 - BACKGROUND: Antipsychotic-related weight gain and metabolic adverse effects have become a major focus, especially in youth. METHODS: Review of randomized, cohort, and pharmacoepidemiologic studies of antipsychotic-related weight gain and metabolic adverse effects and of interventions for their reduction in youth. RESULTS: Across 34 published head-to-head and placebo-controlled studies in youth with psychotic and bipolar disorders, weight gain ranged from 3.8 to 16.2 kg with olanzapine (n=353), 0.9-9.5 kg with clozapine (n=97), 1.9-7.2 kg with risperidone (n=571), 2.3-6.1 kg with quetiapine (n=133), and 0-4.4 kg with aripiprazole (n=451). In 24 placebo-controlled trials, the numbers-needed-to-harm for weight gain ≥7% in youth with bipolar disorder and schizophrenia were 39 (confidence interval [CI]: -1 to +6, not significant) for aripiprazole, 36 (CI: -1 to +7, not significant) for ziprasidone, 9 (CI: 7-14) for quetiapine, 6 (CI: 5-8) for risperidone, and 3 (CI: 3-4) for olanzapine. Data in youth with autism and disruptive behavior disorders, available only for some antipsychotics, suggest greater weight gain, possibly due to less prior antipsychotic exposure. Three-month results from a large cohort study in antipsychotic-naïve youth indicated that metabolic effects differ among second-generation antipsychotics, despite significant weight gain with all studied agents, suggesting additional, weight-independent effects. Further, pharmacoepidemiologic work indicates that antipsychotic polypharmacy increases the risk for obesity (odds ratio [OR]: 2.28 [CI: 1.49-3.65]) or any cardiovascular, cerebrovascular, or hypertensive adverse event (OR: 1.72 [CI: 1.10-2.69]). However, despite marked weight gain and its greater impact on youth, monitoring rates are low and studies of pharmacologic and behavioral interventions are extremely limited. CONCLUSIONS: More research is needed to develop strategies to minimize antipsychotic-related weight gain and metabolic effects in youth and to discover treatments with lower risk potential. SN - 1557-8992 UR - https://www.unboundmedicine.com/medline/citation/22166172/Weight_gain_and_metabolic_risks_associated_with_antipsychotic_medications_in_children_and_adolescents_ L2 - https://www.liebertpub.com/doi/10.1089/cap.2011.0015?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -