Safety Alert: Quetiapine
Newer Antipsychotics Associated with Significant Weight Gain With Short-Term Use in Children and Adolescents
An article recently published in the Journal of the American Medical Association links the newer atypical antipsychotics such as aripiprazole (Abilify), olanzapine (Zyprexa), quetiapine (Seroquel), and risperidone (Risperdal), with weight gain and increases in insulin, glucose, cholesterol, and triglyceride levels in children and adolescents age 4 to 19 years who took these medicines for 11 weeks. By the end of this study, patient weight increased by 18.7 pounds with olanzapine (Zyprexa), by 13.4 pounds with quetiapine (Seroquel), by 11.7 pounds with risperidone (Risperdal), and by 9.7 pounds with aripiprazole (Abilify).
Antipsychotics are becoming more commonly used for many different mood and behavior conditions, especially in children, adolescents, and young adults. Although FDA approvals vary by drug, the newer antipsychotics are used for a variety of psychological conditions, including schizophrenia, autism, and bipolar disorder. However, they are also prescribed "off-label" to treat attention deficit hyperactivity disorder (ADHD) and other mood and behavior disorders.
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What does this mean?
Most doctors are familiar with the concerns about the safety of antipsychotics. Weight gain and increases in metabolic markers, such as glucose, insulin, triglycerides, and cholesterol, are well known side effects of the newer antipsychotics. Over time, these side effects can lead to diabetes, high blood pressure, obesity, and other serious conditions. This is the first study in children and adolescents to show that the weight gain and metabolic changes associated with these medicines can occur quickly with short-term use.
Although the side effects of the newer antipsychotics are concerning, untreated mood and behavior problems can cause psychological suffering. These study results are a reminder to patients and caregivers about the importance of regularly discussing the use of these medicines with their doctors and determining if the benefits of the medicine continue to outweigh the risks. This discussion should also address ways to improve factors that may reduce risks of heart problems, diabetes, and weight gain such as using the lowest dose of antipsychotic medicine that treats the condition, and maintaining a healthy diet and exercise program.
If you are a caregiver of a child taking an antipsychotic, include your child in discussions with the doctor so that your child can also take an active and informed role in his or her health care.
