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Current follow‐up practices often fail to detect metabolic and neurological adverse reactions in children treated with second‐generation antipsychotics
Author(s) -
Kakko Kirsi,
Pihlakoski Leena,
Keskinen Päivi,
Salmelin Raili,
Puura Kaija
Publication year - 2020
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.14951
Subject(s) - medicine , weight gain , adverse effect , pediatrics , body mass index , retrospective cohort study , body weight
Aim This study examined the use and adverse reactions of second‐generation antipsychotics (SGAs), alone or combined with other psychotropic medication, to identify areas for standardising prescribing and monitoring practices. Methods We conducted a retrospective study at Tampere University Hospital, Finland, involving 128 patients (81% boys) who were under 13 years old at SGA initiation and had SGA treatment between October 2013 and October 2014. Results The median age at baseline was 9.4 years. Weight gain was reported as an adverse reaction in 33%, but an increase in standardised body mass index, adjusted for age and sex (BMI z ‐score), was detected in 75% of patients with sufficient data. The statistically significant median changes during the study were an increase of 0.46 in BMI z ‐score, a reduction of 0.25 mmol/L in fasting plasma high‐density lipoprotein and an increase of 0.28 mmol/L in triglyceride values. The weight gain was most apparent in patients treated with just an SGA or SGA plus melatonin. Patients treated with an SGA plus medication for attention deficit hyperactivity disorder were less likely to gain weight. Conclusion SGA‐induced metabolic disturbances remained partly unrecognised in children under 13 years of age and more systematic monitoring is needed.