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Metabolic and Endocrine Side Effects of Atypical Antipsychotic Drugs in Children and Adolescents

Year 2011, Volume: 3 Issue: 2, 232 - 250, 01.06.2011

Abstract

Comorbid psychiatric disorders, frequent hospitalization, multiple outpatient treatment, prior history of hypertension, obesity and lipid dysregulation are associated with higher risk of metabolic syndrome in children. Side effects of antipsychotic drugs and their management have recently become a major subject of research due to enhanced antipsychotic drug usage in child and adolescents. Prevention strategies are usually preferred to secondary or tertiary strategies in the management of metabolic syndrome associated with antipsychotic drugs. Clinicians should present multidisciplinary approach to endocrine and metabolic side effects due to antipsychotic use in pediatric patient groups and avoid multiple drug use in such patients. In this paper, we briefly reviewed metabolic side effects of second generation antipsychotic drugs in child and adolescent population, possible mechanisms of susceptibility to metabolic syndrome and pharmacological and non pharmacological treatment approach to prevention of weight gain.

References

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Çocuk ve Ergenlerde Atipik Antipsikotik İlaçların Metabolik ve Endokrin Yan Etkileri

Year 2011, Volume: 3 Issue: 2, 232 - 250, 01.06.2011

Abstract

Çocuklarda eş tanılı psikiyatrik bozukluklar, sık hastaneye yatış, ayaktan tedavi başvurularının fazlalığı ve hipertansiyon, obezite ve lipid bozuklukları öyküsü yüksek metabolik sendrom riski ile ilişkilendirilmiştir. Çocuk ve ergenlerde antipsikotik ilaç kullanımının artması nedeniyle ilaç yan etkileri ve bu yan etkilerin yönetimi de önem kazanmaktadır. Literatürde genel olarak antipsikotiklerle ilişkili metabolik sendromda önleyici yaklaşımların ikincil ve üçüncül yaklaşımlara göre daha çok tercih edildiği vurgulanmıştır. Klinisyenlerin çocuk ve ergen hasta grubunda antipsikotik ilaç kullanımına bağlı endokrin ve metabolik yan etkilere multidisipliner yaklaşım sergilemeleri ve çoklu ilaç kullanımından kaçınmaları önerilmektedir. Bu yazıda çocuk ve ergen hasta grubunda ikinci kuşak antipsikotik ilaçların metabolik yan etkileri, metabolik sendroma yatkınlığın olası nedenleri ve kilo artışını önlemeye yönelik farmakolojik ve farmakolojik olmayan tedavi yaklaşımları kısaca gözden geçirilmiştir.

References

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  • Cooper WO, Arbogast PG, Ding H, Hickson GB, Fuchs DC, Ray WA. Trends in prescribing of antipsychotic medications for US children. Ambul Pediatr 2006; 6:79
  • Olfson M, Blanco C, Lui L, Moreno C, Laje G. National trends in the outpatient treatment of children and adolescents with antipsychotic drugs. Arch Gen Psychiatry 2006; 63: 679- 685.
  • Taş F, Güvenir T, Miral S. Bir çocuk ve ergen psikiyatrisi kliniğinde yatarak tedavi gören hastalarda ilaç kullanımı. Çocuk ve Gençlik Ruh Sağlığı Dergisi 2007; 14:139- 150.
  • McIntyre RS, Jerrell JM. Metabolic and cardiovascular adverse events associated with antipsychotic treatment in children and adolescents. Arch Pediatr Adolesc Med 2008;
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  • Öyekçin DG. Bir grup şizofreni ve şizoaffektif bozukluk hastasında metabolik send- rom sıklığı. Anadolu Psikiyatri Dergisi 2009; 10:26-33.
  • Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH. Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988-1994. Arch Pediatr Adolesc Med 1994; 157:821- 827.
  • Dhillo WS. Appetite regulation: an overview. Thyroid 2007; 17: 433-445.
  • Fernandez JR, Redden DT, Pietrobelli A, Allison DB. Waist circumference percentiles in nationally representative samples of African American, European- American, and Mexican-American children and adolescents. J Pediatr 2004; 145:439- 444.
  • Correll CU, Carlson HE. Endocrin and metabolic adverse effects of psychotropic medications in children and adolescents. J Am Acad Child Adolesc Psychiatry 2006; 45: 771- 791.
  • Correll CU. Multiple antipsychotic use associated with metabolic and cardiovascular adverse events in children and adolescents. Evid Based Ment Health 2009; 12:93.
  • Bjorntorp P Heart and soul: stress and the metabolic syndrome. Scand Cardiovasc J 2001; 35:172-177.
  • Dwyer DS, Weeks KR, Aamodt EJ. Drug discovery based on genetic and metabolic findings in schizophrenia. Expert Rev Clin Pharmacol 2008; 1:773-789.
  • Ellingrod VL, Miller D, Taylor S, Moline J, Holman T, Kerr J. Metabolic syndrome and insulin resistance in schizophrenia patients receiving antipsychotics genotyped for the Methylene tetrahydro folate Reductase (MTHFR) 677C/T and 1298A/C Variants. Schizophr Res 2008; 98:47-54.
  • Burkart J, Fox R, Rotatori A. Obesity of mentally retarded individuals: prevalence, characteristics, and intervention. Am J Ment Defic 1985; 90:303-312.
  • Kang SG, Lee HJ, Park YM, Choi JE, Han C, Kim YK et al. Possible association between the 2548 A/G polymorphism of the leptin gene and olanzapin induced weight gain. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32:160-163.
  • Pena R, Marquiana D, Serrano A, Elfakih Y, de Baptista EA, Carrizo E et al. Frequency of abnormal correlation between leptin and body mass index during first and second generation antipsychotic drug treatment Schizophr Res 2008; 106:315- 319.
  • Jerrell JM, McInytre RS. Adverse events in children and adolescents treated with antipsychotic medications. Hum Psychopharmacol Clin Exp 2008; 23:283-290.
  • Kelly DL, Love RC, Mackowick M, McMahon RP, Conley RR. Atypical antipsychotic use in a state hospital inpatient adolescent population. J Child Adolesc Psychopharmacol 2004; 14:75-85.
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  • Gothelf D, Falk B, Singer P, Kairi M, Phillip M, Zigel L et al. Weight gain associated with increased food intake and low habitual activity levels in male adolescent schizophrenic inpatients treated with olanzapine. Am J Psychiatry 2002; 159:1055- 1057
  • Allison D, Mentore J, Heo M, Chandler LP, Cappelleri JC, Infante MC et al. Antipsychotic-induced weight gain: a comprehensive research synthesis. Am J Psychiatry 1999; 156:1686-1696.
  • Lin SK, Chen CK. Reversal of antipsychotic-ınduced hyperprolactinemia, weight gain, and dyslipidemia by aripiprazole: A case report. J Clin Psychiatry 2006; 67:1307.
  • Kirk S, Neill JC, Jones DN, Reynolds GP. Ziprasidone suppresses olanzapine- induced increases in ingestive behaviour in the rat. Eur J Pharmacol 2004; 505:253- 254.
  • Kroeze WK, Hufeisen SJ, Popadak BA, Renock SM, Steinberg S, Ernsberger P et al. H1-histamine, receptor affinity predicts short-term weight gain for typical and atypical antipsychotic drugs. Neuropsychopharmacology 2003; 28:519-526.
  • Nasrallah HA. Atypical antipsychotic-induced metabolic side effects: Insights from receptor-binding profiles. Mol Psychiatry 2008; 13:27-35.
  • Casey DE, Sands EE, Heisterberg J, Yang HM. Efficacy and safety of bifeprunox in patients with an acute exacerbation of schizophrenia: results from a randomized, double-blind, placebo-controlled, multicenter, dose-finding study. Psychopharmacology (Berl) 2008; 200:317-331.
  • Patel NC, Hariparsad M, Matias-Akthar M, Sorter MT, Barzman DH, Morrison JA, Body mass indexes and lipid profiles in hospitalized children and adolescents exposed to atypical antipsychotics. J Child Adolesc Psychopharmacol 2007; 17:303-311.
  • Tohen M, Kryzhanovskaya L, Carlson G, Delbello M, Wozniak J, Kowatch R et al. Olanzapine versus placebo in the treatment of adolescents with bipolar mania. Am J Psychiatry 2007; 164:1547-1556.
  • Hoffman RP. Indices of insulin action calculated from fasting glucose and insulin reflect hepatic, not peripheral, insulin sensitivity in African-American and Caucasian adolescents. Pediatr Diabetes 2008; 9:57-61.
  • McLaughlin T, Reaven G, Abbasi F, Lamendola C, Saad M, Waters D et al. Is there a simple way to identify insulin-resistant individuals at increased risk of cardiovascular disease? Am J Cardiol 2005; 96:399-404.
  • Woods SW, Martin A, Spector SG, McGlashan TH. Effects of development on olanzapine-associated adverse events. J Am Acad Child Adolesc Psychiatry 2002;
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There are 92 citations in total.

Details

Primary Language Turkish
Journal Section Review
Authors

Gonca Gül Çelik This is me

Ayşegül Tahiroğlu This is me

Ayşe Avcı This is me

Publication Date June 1, 2011
Published in Issue Year 2011 Volume: 3 Issue: 2

Cite

AMA Çelik GG, Tahiroğlu A, Avcı A. Çocuk ve Ergenlerde Atipik Antipsikotik İlaçların Metabolik ve Endokrin Yan Etkileri. Psikiyatride Güncel Yaklaşımlar - Current Approaches in Psychiatry. June 2011;3(2):232-250.

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