Burak Baykara Hüseyin, Alşen Güney Sevay, Avcil Sibelnur, Buran Burçin Şeyda, Ogulcan Cıray Remzi, Ermis Cagatay, Inal Neslihan
Department of Child and Adolescent Psychiatry, Dokuz Eylül University, Faculty of Medicine, Izmir, Türkiye.
Department of Child and Adolescent Psychiatry, Aydın Adnan Menderes University, Faculty of Medicine, Aydın, Türkiye.
Psychiatry Clin Psychopharmacol. 2024 Jun 1;34(2):109-118. doi: 10.5152/pcp.2024.23726. eCollection 2024 Jun.
This study's objective was to investigate the adverse effects of atypical antipsychotics (AAPs) on the metabolic, hematological, and endocrinological systems in the inpatient environment for children and adolescents with diverse psychiatric disorders.
A retrospective assessment of 208 children's and adolescents' medical records was conducted. All patients were on AAP monotherapy. At baseline and after treatment, measurements of body weight, height, body mass index (BMI), BMI z-score, fasting blood glucose (FBG), total cholesterol, low-density lipoprotein cholesterol, triglycerides, high-density lipoprotein cholesterol, complete blood count, liver functions, thyroid functions, and prolactin levels were made. Scores from the Children's Global Assessment Scale (CGAS) and the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) were preserved.
The overall patient population had a mean age of 14.50 ± 2.32 years, 139 girls, and 69 boys. Of the patients, 63 (30.29%) were on risperidone (RIS), 69(33.17%) were on aripiprazole (ARI), 32 (15.39%) were on quetiapine (QUE), 42 (20.19%) were on olanzapine (OLA), and 2 (0.96%) were on clozapine (CLO). In the OLA group, the BMI and BMI z-score increased more than in the RIS, QUE, and ARI groups ( = .030, = .014, and = .001, respectively) ( = .001). The mean difference in CGAS and HoNOSCA between the start of antipsychotic medication and hospital discharge was statistically different for all four groups ( = .001 for all). The mean FBG levels in the OLA group increased statistically significantly ( = .013, = .021) in contrast to the RIS group. In addition, a statistically significant difference in triglycerides across the groups was found ( = .003).
According to the findings of our study, children and adolescents appear to be at a significant risk for psychotropic-induced PRL increase, weight gain, metabolic, and hematological consequences. To prevent serious health problems, a meticulous risk-benefit assessment for AAPs treatment should be done between clinicians and patients and their families.
本研究的目的是调查非典型抗精神病药物（AAPs）对患有多种精神疾病的儿童和青少年住院患者代谢、血液和内分泌系统的不良影响。
对208名儿童和青少年的病历进行回顾性评估。所有患者均接受AAP单一疗法。在基线和治疗后，测量体重、身高、体重指数（BMI）、BMI z评分、空腹血糖（FBG）、总胆固醇、低密度脂蛋白胆固醇、甘油三酯、高密度脂蛋白胆固醇、全血细胞计数、肝功能、甲状腺功能和催乳素水平。保留儿童总体评估量表（CGAS）和儿童青少年国家健康结果量表（HoNOSCA）的评分。
患者总体平均年龄为14.50±2.32岁，其中女孩139名，男孩69名。患者中，63名（30.29%）服用利培酮（RIS），69名（33.17%）服用阿立哌唑（ARI），32名（15.39%）服用喹硫平（QUE），42名（20.19%）服用奥氮平（OLA），2名（0.96%）服用氯氮平（CLO）。在OLA组中，BMI和BMI z评分的增加幅度大于RIS、QUE和ARI组（分别为=0.030、=0.014和=0.001）（=0.001）。所有四组在开始使用抗精神病药物至出院期间CGAS和HoNOSCA的平均差异均有统计学意义（所有组均为=0.001）。与RIS组相比，OLA组的平均FBG水平有统计学显著升高（=0.013，=0.021）。此外，各组之间甘油三酯存在统计学显著差异（=0.003）。
根据我们的研究结果，儿童和青少年似乎面临精神药物引起的催乳素升高、体重增加、代谢和血液学后果的重大风险。为预防严重健康问题，临床医生应与患者及其家属对AAPs治疗进行细致的风险效益评估。
