Management recommendations for metabolic complications associated with second generation antipsychotic use in children and youth
- PMID: 21804854
- PMCID: PMC3143701
Management recommendations for metabolic complications associated with second generation antipsychotic use in children and youth
Abstract
Background: Second generation antipsychotics (SGAs) are commonly associated with metabolic complications. These medications are being used more frequently for the treatment of mental health disorders in children, which has stimulated the need for creating formal guidelines on monitoring their safety and effectiveness. Previous guidelines have been developed for monitoring for metabolic and neurological complications. In order to assist practitioners who perform these monitoring procedures, we have created a complementary set of treatment recommendations if abnormal measurements or results are encountered.
Objective: To create evidence-based recommendations to assist in managing metabolic complications in children being treated with second generation antipsychotics.
Methods: A systematic review of the literature on metabolic complications of second generation antipsychotic medications in children was conducted. Members of the consensus group evaluated the information gathered from the systematic review of the literature and used a nominal group process to come to consensus on treatment recommendations. Wherever possible, references were made to existing guidelines on the evaluation and treatment of metabolic abnormalities in children.
Results: Evidence-based recommendations are presented to assist in managing metabolic complications, including weight gain, increased waist circumference, elevation in cholesterol, triglycerides and glucose, liver function tests, abnormal thyroid studies, and elevation in prolactin.
Conclusion: The use of SGAs requires proper monitoring procedures. This treatment guideline provides guidance to clinicians on clinical management of metabolic complications if they occur.
References
-
- Alfaro CL, Wudarsky M, Nicolson R, Gochman P, Sporn A, Lenane M, Rapoport J. Correlation of antipsychotic and prolactin concentrations in children and adolescents acutely treated with haloperidol, clozapine, or olanzapine. Journal of Child and Adolescent Psychopharmacology. 2002;12(2):83–91. - PubMed
-
- Alvarez-Jimenez M, Gonzalez-Blanch C, Vazquez-Barquero JL, Perez-Iglesias R, Martinez-Garcia O, Perez-Pardal T, Crespo-Facorro B. Attenuation of antipsychotic-induced weight gain with early behavioral intervention in drug-naive first-episode psychosis patients: A randomized controlled trial. Journal of Clinical Psychiatry. 2006;67(8):1253–1260. - PubMed
-
- Arman S, Sadramely MR, Nadi M, Koleini N. A randomized, double-blind, placebo-controlled trial of metformin treatment for weight gain associated with initiation of risperidone in children and adolescents. Saudi Medical Journal. 2008;29(8):1130–1134. - PubMed
-
- Brozek JL, Akl EA, Alonso-Coello P. Grading quality of evidence and strength of recommendations in clinical practice guidelines. Part 1 of 3 An overview of the GRADE approach and grading quality of evidence about interventions. Allergy. 2009;64(5):669–677. al., e. - PubMed
-
- Brozek JL, Akl EA, Alonso-Coello P, Lang D, Jaeschke R, Williams JW, GRADE Working Group Grading quality of evidence and strength of recommendations in clinical practice guidelines. Part 1 of 3 An overview of the GRADE approach and grading quality of evidence about interventions. Allergy. 2009;64(5):669–677. - PubMed
LinkOut - more resources
Full Text Sources