Avrahami Matan, Peskin Miriam, Moore Tyler, Drapisz Adi, Taylor Jerome, Segal-Gavish Hadar, Balan-Moshe Livia, Shachar Issac, Levy Tomer, Weizman Abraham, Barzilay Ran
Child and Adolescent Division, Geha Mental Health Centre, Tel Aviv University Sackler Faculty of Medicine, Petakh Tikva, Israel.
Psychiatry, Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine, Child and Adolescent Psychiatry and Behavioral Sciences, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA.
J Psychopharmacol. 2021 Sep;35(9):1134-1140. doi: 10.1177/02698811211008592. Epub 2021 Apr 23.
Use of risperidone in preschool-aged children is growing, with rising concerns of adverse metabolic consequences. Longitudinal data on risperidone-related weight gain in preschoolers are scarce. We aimed to evaluate changes in body mass index (BMI) that are associated with risperidone treatment in preschoolers.
We analyzed naturalistic, longitudinal data on 141 preschool children (112 boys, 29 girls) receiving psychiatric care. Mean patient age at baseline was 5.0 years (SD=0.8) and average follow-up period was 1.3 years (SD=0.8), with >8 mean BMI measurements per patient. We studied the effect of risperidone exposure (=78) on age-and-sex-standardized BMI (BMI Z-score) implementing mixed models with random subject intercepts to account for repeated measures, covarying for multiple confounders including demographics, stimulant treatment and psychiatric diagnoses. We employed similar models to study dose and duration effects.
Risperidone treatment was significantly associated with an increase in BMI (effect size of exposure=0.45 SD (SE=0.06), (949)=7.7, <0.001) covarying for stimulant exposure and other confounders, independent of treatment indication. Females exhibited stronger effects (risperidone treatment × sex interaction =2.32, =0.02)). Risperidone daily dose was associated with increase in BMI (for each additional 1 mg, effect size=0.28 SD (SE=0.07), (419)=3.76, <0.001).
Similar to older populations, risperidone treatment in preschoolers is associated with significant weight gain, with evidence for dose effects. Findings provide critical data that can inform clinicians.
利培酮在学龄前儿童中的使用日益增加，人们对其不良代谢后果的担忧也与日俱增。关于学龄前儿童使用利培酮导致体重增加的纵向数据稀缺。我们旨在评估学龄前儿童使用利培酮治疗与体重指数（BMI）变化之间的关联。
我们分析了141名接受精神科护理的学龄前儿童（112名男孩，29名女孩）的自然纵向数据。基线时患者的平均年龄为5.0岁（标准差=0.8），平均随访期为1.3年（标准差=0.8），每名患者平均有超过8次BMI测量值。我们采用带有随机受试者截距的混合模型来研究利培酮暴露（=78）对年龄和性别标准化BMI（BMI Z评分）的影响，以考虑重复测量，并对包括人口统计学、兴奋剂治疗和精神科诊断在内的多个混杂因素进行协变量调整。我们采用类似模型来研究剂量和疗程的影响。
在对兴奋剂暴露和其他混杂因素进行协变量调整后，利培酮治疗与BMI增加显著相关（暴露效应大小=0.45标准差（标准误=0.06），（949）=7.7，<0.001），且与治疗指征无关。女性的效应更强（利培酮治疗×性别交互作用=2.32，=0.02）。利培酮每日剂量与BMI增加相关（每增加1毫克，效应大小=0.28标准差（标准误=0.07），（419）=3.76，<0.001）。
与年龄较大的人群相似，学龄前儿童使用利培酮治疗与显著体重增加相关，且有剂量效应的证据。研究结果为临床医生提供了关键数据。
