Psychiatry and Clinical Psychopharmacology
Original Article

Safety of Atypical Antipsychotics in a Child and Adolescent İnpatient Setting: A Naturalistic Study

1.

Department of Child and Adolescent Psychiatry, Dokuz Eylül University, Faculty of Medicine, Izmir, Turkey

2.

Department of Child and Adolescent Psychiatry, Aydın Adnan Menderes University, Faculty of Medicine, Aydın, Turkey

3.

Department of Child and Adolescent Psychiatry, Balıkesir Atatürk City Hospital, Balıkesir, Turkey

4.

Department of Child and Adolescent Psychiatry, Mardin Training and Research Hospital, Mardin, Turkey

5.

Department of Child and Adolescent Psychiatry, Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Göteborg, Sweden

Psychiatry and Clinical Psychopharmacology 2024; 34: 109-118
DOI: 10.5152/pcp.2024.23726
Read: 239 Downloads: 128 Published: 04 March 2024

Background: This study’s objective was to investigate the adverse effects of atypical antipsychotics (AAPs) on the metabolic, hematological, and endocrinological systems in the inpatient environment for children and adolescents with diverse psychiatric disorders.

Methods: A retrospective assessment of 208 children’s and adolescents’ medical records was conducted. All patients were on AAP monotherapy. At baseline and after treatment, measurements of body weight, height, body mass index (BMI), BMI z-score, fasting blood glucose (FBG), total cholesterol, low-density lipoprotein cholesterol, triglycerides, high-density lipoprotein cholesterol, complete blood count, liver functions, thyroid functions, and prolactin levels were made. Scores from the Children’s Global Assessment Scale (CGAS) and the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) were preserved.

Results: The overall patient population had a mean age of 14.50 ± 2.32 years, 139 girls, and 69 boys. Of the patients, 63 (30.29%) were on risperidone (RIS), 69(33.17%) were on aripiprazole (ARI), 32 (15.39%) were on quetiapine (QUE), 42 (20.19%) were on olanzapine (OLA), and 2 (0.96%) were on clozapine (CLO). In the OLA group, the BMI and BMI z-score increased more than in the RIS, QUE, and ARI groups (P = .030, P = .014, and P = .001, respectively) (P = .001). The mean difference in CGAS and HoNOSCA between the start of antipsychotic medication and hospital discharge was statistically different for all four groups (P = .001 for all). The mean FBG levels in the OLA group increased statistically significantly (P = .013, P = .021) in contrast to the RIS group. In addition, a statistically significant difference in triglycerides across the groups was found (P = .003).

Conclusion: According to the findings of our study, children and adolescents appear to be at a significant risk for psychotropic-induced PRL increase, weight gain, metabolic, and hematological consequences. To prevent serious health problems, a meticulous riskbenefit assessment for AAPs treatment should be done between clinicians and patients and their families.

Cite this article as: Baykara HB, Alşen Güney S, Avcil S, et al. Safety of atypical antipsychotics in a child and adolescent inpatient setting: A naturalistic study. Psychiatry Clin Psychopharmacol. 2024;34(2):109-118.

Files
EISSN 2475-0581