Tags

Type your tag names separated by a space and hit enter

Safety of 80 antidepressants, antipsychotics, anti-attention-deficit/hyperactivity medications and mood stabilizers in children and adolescents with psychiatric disorders: a large scale systematic meta-review of 78 adverse effects.
World Psychiatry. 2020 Jun; 19(2):214-232.WP

Abstract

Mental disorders frequently begin in childhood or adolescence. Psychotropic medications have various indications for the treatment of mental dis-orders in this age group and are used not infrequently off-label. However, the adverse effects of these medications require special attention during developmentally sensitive periods of life. For this meta-review, we systematically searched network meta-analyses and meta-analyses of randomized controlled trials (RCTs), individual RCTs, and cohort studies reporting on 78 a priori selected adverse events across 19 categories of 80 psychotropic medications - including antidepressants, antipsychotics, anti-attention-deficit/hyperactivity disorder (ADHD) medications and mood stabilizers - in children and adolescents with mental disorders. We included data from nine network meta-analyses, 39 meta-analyses, 90 individual RCTs, and eight cohort studies, including 337,686 children and adolescents. Data on ≥20% of the 78 adverse events were available for six antidepressants (sertraline, escitalopram, paroxetine, fluoxetine, venlafaxine and vilazodone), eight antipsychotics (risperidone, quetiapine, aripiprazole, lurasidone, paliperidone, ziprasidone, olanzapine and asenapine), three anti-ADHD medications (methylphenidate, atomoxetine and guanfacine), and two mood stabilizers (valproate and lithium). Among these medications with data on ≥20% of the 78 adverse events, a safer profile emerged for escitalopram and fluoxetine among antidepressants, lurasidone for antipsychotics, methylphenidate among anti-ADHD medications, and lithium among mood stabilizers. The available literature raised most concerns about the safety of venlafaxine, olanzapine, atomoxetine, guanfacine and valproate. Nausea/vomiting and discontinuation due to adverse event were most frequently associated with antidepressants; sedation, extrapyramidal side effects, and weight gain with antipsychotics; anorexia and insomnia with anti-ADHD medications; sedation and weight gain with mood stabilizers. The results of this comprehensive and updated quantitative systematic meta-review of top-tier evidence regarding the safety of antidepressants, antipsychotics, anti-ADHD medications and mood stabilizers in children and adolescents can inform clinical practice, research and treatment guidelines.

Authors+Show Affiliations

Neurosciences Department, University of Padua, Padua, Italy. Padua Neuroscience Center, University of Padua, Padua, Italy. Early Psychosis: Interventions and Clinical-detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.Department of Psychiatry, Federico II University, Naples, Italy.Oxford Health NHS Foundation Trust, Warneford Hospital, and Department of Psychiatry, University of Oxford, Oxford, UK. Department of Health Sciences, University of Milan, Milan, Italy.Department of Health Sciences, University of Milan, Milan, Italy.Neurosciences Department, University of Padua, Padua, Italy.Department of Mental Health, ASL, Salerno, Salerno, Italy.Integrated Psychiatry Winterthur (IPW), Winterthur, Switzerland.Early Psychosis: Interventions and Clinical-detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. OASIS Service, South London & Maudsley NHS Foundation Trust, London, UK. Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy. National Institute for Health Research, Maudsley Biomedical Research Centre, South London & Maudsley NHS Foundation Trust, London, UK.Department of Psychiatry, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York, NY, USA. Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA. Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA. Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32394557

Citation

Solmi, Marco, et al. "Safety of 80 Antidepressants, Antipsychotics, Anti-attention-deficit/hyperactivity Medications and Mood Stabilizers in Children and Adolescents With Psychiatric Disorders: a Large Scale Systematic Meta-review of 78 Adverse Effects." World Psychiatry : Official Journal of the World Psychiatric Association (WPA), vol. 19, no. 2, 2020, pp. 214-232.
Solmi M, Fornaro M, Ostinelli EG, et al. Safety of 80 antidepressants, antipsychotics, anti-attention-deficit/hyperactivity medications and mood stabilizers in children and adolescents with psychiatric disorders: a large scale systematic meta-review of 78 adverse effects. World Psychiatry. 2020;19(2):214-232.
Solmi, M., Fornaro, M., Ostinelli, E. G., Zangani, C., Croatto, G., Monaco, F., Krinitski, D., Fusar-Poli, P., & Correll, C. U. (2020). Safety of 80 antidepressants, antipsychotics, anti-attention-deficit/hyperactivity medications and mood stabilizers in children and adolescents with psychiatric disorders: a large scale systematic meta-review of 78 adverse effects. World Psychiatry : Official Journal of the World Psychiatric Association (WPA), 19(2), 214-232. https://doi.org/10.1002/wps.20765
Solmi M, et al. Safety of 80 Antidepressants, Antipsychotics, Anti-attention-deficit/hyperactivity Medications and Mood Stabilizers in Children and Adolescents With Psychiatric Disorders: a Large Scale Systematic Meta-review of 78 Adverse Effects. World Psychiatry. 2020;19(2):214-232. PubMed PMID: 32394557.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Safety of 80 antidepressants, antipsychotics, anti-attention-deficit/hyperactivity medications and mood stabilizers in children and adolescents with psychiatric disorders: a large scale systematic meta-review of 78 adverse effects. AU - Solmi,Marco, AU - Fornaro,Michele, AU - Ostinelli,Edoardo G, AU - Zangani,Caroline, AU - Croatto,Giovanni, AU - Monaco,Francesco, AU - Krinitski,Damir, AU - Fusar-Poli,Paolo, AU - Correll,Christoph U, PY - 2020/5/13/entrez PY - 2020/5/13/pubmed PY - 2020/5/13/medline KW - Safety KW - adolescents KW - antidepressants KW - antipsychotics KW - children KW - meta-review KW - mood stabilizers KW - psychopharmacology KW - psycho­stim­ulants KW - tolerability SP - 214 EP - 232 JF - World psychiatry : official journal of the World Psychiatric Association (WPA) JO - World Psychiatry VL - 19 IS - 2 N2 - Mental disorders frequently begin in childhood or adolescence. Psychotropic medications have various indications for the treatment of mental dis-orders in this age group and are used not infrequently off-label. However, the adverse effects of these medications require special attention during developmentally sensitive periods of life. For this meta-review, we systematically searched network meta-analyses and meta-analyses of randomized controlled trials (RCTs), individual RCTs, and cohort studies reporting on 78 a priori selected adverse events across 19 categories of 80 psychotropic medications - including antidepressants, antipsychotics, anti-attention-deficit/hyperactivity disorder (ADHD) medications and mood stabilizers - in children and adolescents with mental disorders. We included data from nine network meta-analyses, 39 meta-analyses, 90 individual RCTs, and eight cohort studies, including 337,686 children and adolescents. Data on ≥20% of the 78 adverse events were available for six antidepressants (sertraline, escitalopram, paroxetine, fluoxetine, venlafaxine and vilazodone), eight antipsychotics (risperidone, quetiapine, aripiprazole, lurasidone, paliperidone, ziprasidone, olanzapine and asenapine), three anti-ADHD medications (methylphenidate, atomoxetine and guanfacine), and two mood stabilizers (valproate and lithium). Among these medications with data on ≥20% of the 78 adverse events, a safer profile emerged for escitalopram and fluoxetine among antidepressants, lurasidone for antipsychotics, methylphenidate among anti-ADHD medications, and lithium among mood stabilizers. The available literature raised most concerns about the safety of venlafaxine, olanzapine, atomoxetine, guanfacine and valproate. Nausea/vomiting and discontinuation due to adverse event were most frequently associated with antidepressants; sedation, extrapyramidal side effects, and weight gain with antipsychotics; anorexia and insomnia with anti-ADHD medications; sedation and weight gain with mood stabilizers. The results of this comprehensive and updated quantitative systematic meta-review of top-tier evidence regarding the safety of antidepressants, antipsychotics, anti-ADHD medications and mood stabilizers in children and adolescents can inform clinical practice, research and treatment guidelines. SN - 1723-8617 UR - https://www.unboundmedicine.com/medline/citation/32394557/Safety_of_80_antidepressants,_antipsychotics,_anti-attention-deficit/hyperactivity_medications_and_mood_stabilizers_in_children_and_adolescents_with_psychiatric_disorders:_a_large_scale_systematic_meta-review_of_78_adverse_effects L2 - https://doi.org/10.1002/wps.20765 DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.