OBJECTIVES: The aims of this study were to provide a systematic review and meta-analysis of the effects of atypical antipsychotics in children and adolescents on weight gain (primary objective) and other metabolic parameters (secondary objective). METHODS: A systematic literature review and meta-analysis of double-blind, randomized, controlled trials were conducted. The data sources used were as follows: EMBASE, PubMed, BIOSIS, International Pharmaceutical Abstracts, The Cochrane database (Clinical Trials), Clinical Trials Government Registry, The metaRegister of Controlled Trials, WHO (World Health Organization) Clinical Trials Registry Platform, and PsycINFO(®). Hand searching was also carried out by examining the reference lists of identified studies. Double-blind, randomized, controlled trials investigating the metabolic adverse effects (weight gain, lipid, glucose, and prolactin level abnormalities) associated with atypical antipsychotic use in children and adolescents aged ≤ 18 years were included, irrespective of whether the investigation of adverse effects was a primary or secondary endpoint. RESULTS: We identified 21 studies of drug versus placebo that met the inclusion criteria, with a total of 2,455 patients, 14 studies for risperidone (1,331 patients), three for olanzapine (276 patients), and four for aripiprazole (848 patients). Compared with placebo, the mean weight increases for each drug were olanzapine 3.45 kg (95 % CI 2.93-3.98), risperidone 1.77 kg (95 % CI 1.35-2.20), and aripiprazole 0.94 kg (95 % CI 0.65-1.24). Regarding other metabolic abnormalities, eight studies reported statistically significant increases in prolactin with risperidone; two reported a statistically significant increase in glucose, total cholesterol, and prolactin with olanzapine; and three studies reported a statistically significant decrease in prolactin with aripiprazole. Data on lipid, glucose, and prolactin level changes were too limited to allow us to perform a meta-analysis. CONCLUSIONS: Olanzapine, risperidone, and aripiprazole were all associated with statistically significant weight gain. Olanzapine was associated with the most weight gain and aripiprazole the least. For the secondary outcome, although a number of active comparator trials were identified, data were not available for meta-analysis and were too limited to allow firm conclusions to be drawn.
OBJECTIVES: The aims of this study were to provide a systematic review and meta-analysis of the effects of atypical antipsychotics in children and adolescents on weight gain (primary objective) and other metabolic parameters (secondary objective). METHODS: A systematic literature review and meta-analysis of double-blind, randomized, controlled trials were conducted. The data sources used were as follows: EMBASE, PubMed, BIOSIS, International Pharmaceutical Abstracts, The Cochrane database (Clinical Trials), Clinical Trials Government Registry, The metaRegister of Controlled Trials, WHO (World Health Organization) Clinical Trials Registry Platform, and PsycINFO(®). Hand searching was also carried out by examining the reference lists of identified studies. Double-blind, randomized, controlled trials investigating the metabolic adverse effects (weight gain, lipid, glucose, and prolactin level abnormalities) associated with atypical antipsychotic use in children and adolescents aged ≤ 18 years were included, irrespective of whether the investigation of adverse effects was a primary or secondary endpoint. RESULTS: We identified 21 studies of drug versus placebo that met the inclusion criteria, with a total of 2,455 patients, 14 studies for risperidone (1,331 patients), three for olanzapine (276 patients), and four for aripiprazole (848 patients). Compared with placebo, the mean weight increases for each drug were olanzapine 3.45 kg (95 % CI 2.93-3.98), risperidone 1.77 kg (95 % CI 1.35-2.20), and aripiprazole 0.94 kg (95 % CI 0.65-1.24). Regarding other metabolic abnormalities, eight studies reported statistically significant increases in prolactin with risperidone; two reported a statistically significant increase in glucose, total cholesterol, and prolactin with olanzapine; and three studies reported a statistically significant decrease in prolactin with aripiprazole. Data on lipid, glucose, and prolactin level changes were too limited to allow us to perform a meta-analysis. CONCLUSIONS:Olanzapine, risperidone, and aripiprazole were all associated with statistically significant weight gain. Olanzapine was associated with the most weight gain and aripiprazole the least. For the secondary outcome, although a number of active comparator trials were identified, data were not available for meta-analysis and were too limited to allow firm conclusions to be drawn.
Authors: George M Anderson; Lawrence Scahill; James T McCracken; Christopher J McDougle; Michael G Aman; Elaine Tierney; L Eugene Arnold; Andrés Martin; Liliya Katsovich; David J Posey; Bhavik Shah; Benedetto Vitiello Journal: Biol Psychiatry Date: 2006-05-30 Impact factor: 13.382
Authors: R L Findling; N K McNamara; L A Branicky; M D Schluchter; E Lemon; J L Blumer Journal: J Am Acad Child Adolesc Psychiatry Date: 2000-04 Impact factor: 8.829
Authors: Ludmila A Kryzhanovskaya; Carol K Robertson-Plouch; Wen Xu; Janice L Carlson; Karen M Merida; Ralf W Dittmann Journal: J Clin Psychiatry Date: 2009-02-10 Impact factor: 4.384
Authors: Ronald N Marcus; Randall Owen; Lisa Kamen; George Manos; Robert D McQuade; William H Carson; Michael G Aman Journal: J Am Acad Child Adolesc Psychiatry Date: 2009-11 Impact factor: 8.829
Authors: Magali Haas; Alan S Unis; Jorge Armenteros; Margaret D Copenhaver; Jorge A Quiroz; Stuart F Kushner Journal: J Child Adolesc Psychopharmacol Date: 2009-12 Impact factor: 2.576
Authors: Noor B Almandil; Rohit J Lodhi; Hongyan Ren; Frank M C Besag; David Rossolatos; Ruth Ohlsen; Caitlin Slomp; Diego L Lapetina; Giona Plazzotta; Macey L Murray; Abdulsalam A Al-Sulaiman; Paul Gringras; Ian C K Wong; Katherine J Aitchison Journal: Mol Neuropsychiatry Date: 2018-10-05
Authors: Johanna K Lake; Danica Denton; Yona Lunsky; Amy M Shui; Jeremy Veenstra-VanderWeele; Evdokia Anagnostou Journal: J Autism Dev Disord Date: 2017-05
Authors: Jade Yap; Claire McCartan; Gavin Davidson; Chris White; Liam Bradley; Paul Webb; Jennifer Badham; Gavin Breslin; Paul Best Journal: Health Expect Date: 2020-10-09 Impact factor: 3.377
Authors: Lawrence Scahill; Sangchoon Jeon; Susan J Boorin; Christopher J McDougle; Michael G Aman; James Dziura; James T McCracken; Sonia Caprio; L Eugene Arnold; Ginger Nicol; Yanhong Deng; Saankari A Challa; Benedetto Vitiello Journal: J Am Acad Child Adolesc Psychiatry Date: 2016-03-07 Impact factor: 8.829