Last week I ran a need-to-know series on the atypical antipsychotics. In Part Two I expressed my alarm over the cavalier manner in which theyre being prescribed for children and teens.
Heres a link to the first in the series.
In follow-up, Id like to share a bit of research that underscores my concern(s).
The Problem & the Study
When the studys lead investigator, Dr. John W. Newcomer, MD, was chair of the Drug Utilization Review Board for Missouri Medicaid he noticed something unusual. It seems antipsychotic prescriptions for children were increasing, but schizophrenic diagnoses werent.
Care to know why the antipsychotics were being prescribed? For disruptive behavior disorders.
It was also known that children who are first-time users of antipsychotics experience prolific cardiometabolic changes within weeks of the initiation of treatment.
These changes often lead to insulin resistance and increased adiposity (of or relating to fat). And, of course, early cardiovascular disease and death may result.
Enter the study, Metabolic Effects of Antipsychotics in Children. The work was conducted at the University of Miami (Florida, US) Miller School of Medicine, and funded by the National Institute of Mental Health.
Its mission was to characterize changes in adiposity and insulin sensitivity in children receiving their first course of antipsychotic treatment.
The study participants were 125 aggressive children aged 6-18 whod never used an antipsychotic. They were administered aripiprazole (Abilify), risperidone (Risperdal), or olanzapine (Zyprexa) for a 12-week treatment period.
First of all, there was a significant improvement in behavior using all three meds. In fact, Newcomer and his team were shocked at the results.
Ah, but nothings free. As expected, the cost of the improved behavior was increased body weight and dicey changes in insulin sensitivity.
The biggest fat culprit? Olanzapine (Zyprexa) no great surprise.
The Take Away
Dr. Newcomer believes if a child or adolescent is schizophrenic an antipsychotic has to be prescribed. But he also believes prescribing antipsychotics for disruptive behavior disorders doesnt cut it. Other options have to be explored.
Why? At the very least insulin sensitivity, adiposity, and extrapyramidal side effects.
Think about it, folks. Were prescribing antipsychotic medications to children to manage behavior issues not psychosis. Have we become that easy-way-out focused? What is wrong with this picture?