Adverse events in children and adolescents treated with antipsychotic medications

Objective To report the odds of developing adverse events associated with antipsychotic treatment among children and adolescents. Method A retrospective cohort design evaluating medical and pharmacy claims from one state Medicaid program was used to compare incidence rates for six categories of adverse events of antipsychotic use in 4140 children and adolescents newly prescribed one of six atypical or two conventional antipsychotic medications, January, 1998 to December, 2005 with prevalence rates of these conditions in a random sample of 4500 children not treated with psychotropic medications. Results The odds of developing obesity/excessive weight gain, Type II diabetes and dyslipidemia, digestive/urogenital problems, and neurological/sensory symptoms were higher for females and those prescribed multiple antipsychotic medications. The odds of developing cardiovascular conditions were higher for those prescribed multiple antipsychotic medications and haloperidol. The odds of developing somatic conditions were higher for females, children 12 and under, and those prescribed multiple antipsychotics. Those with lengthy exposure to antipsychotics were at higher risk of developing incident neurological/sensory symptoms. Those treated with concomitant antipsychotic agents were at higher risk of developing somatic problems, and digestive/urogenital conditions. Conclusion Pediatric exposure to antipsychotic polypharmacotherapy confers a higher risk of developing adverse events than monotherapy, especially for females. Copyright (c) 2008 John Wiley & Sons, Ltd.