Antipsychotics and metabolic abnormalities in children and adolescents: a review of the literature and some recommendations
background Adult patients with schizophrenia and bipolar disorder have an increased risk of developing the metabolic syndrome. This is due to their psychiatric illness and to the use of antipsychotic drugs. Children and adolescents are being treated more and more with antipsychotics. The risk of metabolic abnormalities in this age group remains unclear.
aim To investigate the relationship between psychotic disorders in childhood and metabolic abnormalities and to study the influence of the use of both typical and atypical antipsychotics on this relationship.
method The PubMed database was searched for relevant articles published between 2000 and June 2009.
results So far, research into the relationship between psychiatric disorders and metabolic abnormalities in children and adolescents has been inadequate. The normal values and meaning of the components of the metabolic syndrome in children and adolescents have not yet been firmly established. Children and adolescents who use antipsychotics run a significantly higher risk of weight gain. The younger the child, the greater the risk. There are no data about the risk of developing diabetes mellitus type 2. The influence of typical antipsychotics on these conditions has not been investigated.
conclusion The risk of significant weight gain due to the use of atypical antipsychotics is greater in younger children. The ‘metabolic syndrome’ concept is not applicable to children and adolescents. Very little is known about metabolic risks in the long term. Caution is called for in the prescription of antipsychotics for children and adolescents and further research is needed.