Metabolic changes in first‐episode early‐onset schizophrenia with second‐generation antipsychotics

Aim Individuals with a diagnosis of schizophrenia have a reduced life expectancy compared with the general population and cardiovascular disease is the major contributor to this early mortality. The use of second‐generation antipsychotic ( SGA ) medications is associated with significant weight gain and metabolic side effects; however, there is limited knowledge in certain diagnostic groups, specifically early‐onset schizophrenia ( EOS ). This study aimed to investigate the metabolic side effects of SGAs , specifically olanzapine, risperidone and quetiapine, in a cohort of drug‐naïve children and adolescents with first‐episode EOS . Method Body mass index ( BMI ), serum cholesterol and triglycerides were measured at baseline and a median of 7 months of follow up in drug‐naïve children and adolescents with EOS . Results A total of 49 children and adolescents received a diagnosis of first‐episode EOS and we had complete follow‐up data for 74% (N = 36). A significant increase in BMI , serum triglycerides and cholesterol was observed in the unselected cohort after commencement of SGAs . One‐third of children and adolescents had abnormal serum triglycerides and cholesterol; however, a dose–response was not demonstrated. Olanzapine and quetiapine had a greater increase in serum triglycerides. Conclusions I n addition to highlighting the need for routine screening for metabolic side effects in EOS , interventions to prevent and treat obesity and the metabolic syndrome are indicated.