Ebert Tanya, Midbari Yael, Shmilovitz Ronen, Kosov Ira, Kotler Moshe, Weizman Abraham, Ram Anca
1 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .
J Child Adolesc Psychopharmacol. 2014 May;24(4):218-22. doi: 10.1089/cap.2013.0116. Epub 2014 May 9.
Antipsychotics, especially atypical ones, are in common use in children and adolescents with psychotic or affective spectrum disorders, as well as in various other psychopathologies. The adverse effects of atypical antipsychotics in children and adolescents are similar to those seen in adults, and include weight gain, elevated blood glucose levels, and hyperlipidemia. In this retrospective chart review, we compared these adverse events in children who were treated with typical, atypical, or no antipsychotic treatment.
The medical charts of 72 children, 65 boys and 7 girls, were reviewed. All children were 6-13 years old (mean age 9.5±1.7 years). In total, 48 children received antipsychotic treatment, and 24 children were in the control group. Data were extracted from the medical charts, including weight, height, body mass index (BMI), blood pressure, aspartate transaminase (AST), alanine transaminase (ALT), triglycerides, total cholesterol, and glucose blood levels. We examined the values in the beginning of the antipsychotic treatment and at release from the hospital in the study group, and at admission and in the end of the drug-free period or at release from the hospital (a duration of at least 4 weeks) in the control group.
The average weight gain was 3.9±3.8 kg in the atypical antipsychotic treatment (AAT) group, 1.1±4.4 kg in the typical antipsychotic treatment (TAT) group, and 0.23±2.9 kg in the control group. The average increase in BMI was 15.1±22.0 percentiles in the AAT group, 6.4±14.2 percentiles in the TAT group, and 1.6±12.5 percentiles in the control group. No statistically significant difference was found in the increase in height percentile. There were no significant differences in the rates of elevated values of serum triglycerides, cholesterol, AST, ALT, or fasting blood glucose.
We found a significant increase in both absolute weight gain and BMI percentile following atypical antipsychotic treatment. In contrast, typical antipsychotic treatment did not affect weight gain significantly, and the same was true for the control group. In addition, the rates of elevated values of biochemical parameters (AST, ALT, total cholesterol, triglycerides, and fasting blood glucose levels) were very low at the beginning of the study, and were not significantly altered by the various treatments.
抗精神病药物，尤其是非典型抗精神病药物，常用于患有精神病性或情感谱系障碍的儿童和青少年，以及各种其他精神疾病。非典型抗精神病药物在儿童和青少年中的不良反应与成人相似，包括体重增加、血糖水平升高和高脂血症。在这项回顾性病历审查中，我们比较了接受典型、非典型或未接受抗精神病药物治疗的儿童中的这些不良事件。
回顾了72名儿童的病历，其中65名男孩和7名女孩。所有儿童年龄在6至13岁之间（平均年龄9.5±1.7岁）。总共有48名儿童接受了抗精神病药物治疗，24名儿童在对照组。从病历中提取数据，包括体重、身高、体重指数（BMI）、血压、天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）、甘油三酯、总胆固醇和血糖水平。我们检查了研究组抗精神病药物治疗开始时和出院时的值，以及对照组入院时、无药物治疗期结束时或出院时（持续至少4周）的值。
非典型抗精神病药物治疗（AAT）组的平均体重增加为3.9±3.8千克，典型抗精神病药物治疗（TAT）组为1.1±4.4千克，对照组为0.23±2.9千克。AAT组的BMI平均增加百分位数为15.1±22.0，TAT组为6.4±14.2，对照组为1.6±12.5。身高百分位数的增加未发现统计学上的显著差异。血清甘油三酯、胆固醇、AST、ALT或空腹血糖升高值的发生率没有显著差异。
我们发现非典型抗精神病药物治疗后绝对体重增加和BMI百分位数均显著增加。相比之下，典型抗精神病药物治疗对体重增加没有显著影响，对照组也是如此。此外，生化参数（AST、ALT、总胆固醇、甘油三酯和空腹血糖水平）升高值的发生率在研究开始时非常低，并且未因各种治疗而显著改变。
