Información del artículo
Abstract
Over the last few years, there has been a marked increase in the prescription of secondgeneration antipsychotics (SGA) for the treatment of psychotic disorders and other psychiatric conditions in children and adolescents. However, few reports compare the tolerability and efficacy of the different SGAs in this population. We review the literature on the differential characteristics of efficacy and tolerability of SGA in the pediatric population. Our results show that SGAs are not a homogeneous group, but that each drug has a distinct profile, particularly with respect to side effects, especially metabolic complications. Comparisons between SGAs have shown that treatment with olanzapine was associated with greater weight gain and increased cholesterol levels, and that treatment with risperidone was associated with a greater increase in prolactin levels. Therefore, the specific profile of an SGA should be taken into consideration when prescribing these drugs.
Keywords:
Efficacy
Tolerability
Antipsychotic
Psychosis
Pediatric population
Resumen
En los últimos años se ha producido un aumento exponencial en la prescripción de antipsicóticos de segunda generación (ASG) en niños y adolescentes para el tratamiento de trastornos psicóticos y otros trastornos mentales. Sin embargo, hay muy pocos estudios que comparen la tolerabilidad y la eficacia entre los distintos ASG en esta población.Este artículo revisa los datos actuales sobre las características diferenciales de eficacia y tolerabilidad de los ASG en población infanto-juvenil. Los datos muestran que los ASG no forman un grupo homogéneo, sino que cada fármaco de este grupo tiene un perfil característico, sobre todo con respecto a los efectos secundarios, especialmente las complicaciones metabólicas. En concreto, en las comparativas entre ASG, el tratamiento con olanzapina se relacionó con mayor aumento de peso y de colesterol, y el tratamiento con risperidona se asoció con mayor aumento de prolactina. Por ello, antes de prescribir un ASG resulta imprescindible tener en cuenta el perfil diferencial de estos fármacos.
Palabras clave:
Eficacia
Tolerabilidad
Antipsicótico
Psicosis
Población pediátrica
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References
[1.]
C. Arango, M. Parellada, D.M. Moreno.
Clinical effectiveness of new generation antipsychotics in adolescent patients.
Eur Neuropsychopharmacol, 14 (2004), pp. S471-S479
[2.]
R.L. Findling, H. Steiner, E.B. Weller.
Use of antipsychotics in children and adolescents.
J Clin Psychiatry, 66 (2005), pp. 29-40
[3.]
B. Vitiello, C. Correll, B. Van Zwieten-Boot, A. Zuddas, M. Parellada, C. Arango.
Antipsychotics in children and adolescents: increasing use, evidence for efficacy and safety concerns.
Eur Neuropsychopharmacol, 19 (2009), pp. 629-635
[4.]
M. Olfson, C. Blanco, L. Liu, C. Moreno, G. Laje.
National trends in the outpatient treatment of children and adolescents with antipsychotic drugs.
Arch Gen Psychiatry, 63 (2006), pp. 679-685
[5.]
F. Rani, M.L. Murray, P.J. Byrne, I.C. Wong.
Epidemiologic features of antipsychotic prescribing to children and adolescents in primary care in the United Kingdom.
Pediatrics, 121 (2008), pp. 1002-1009
[6.]
N.C. Patel, M.L. Crismon, K. Hoagwood, M.T. Johnsrud, K.L. Rascati, J.P. Wilson, et al.
Trends in the use of typical and atypical antipsychotics in children and adolescents.
J Am Acad Child Adolesc Psychiatry, 44 (2005), pp. 548-556
[7.]
L.J. Kalverdijk, H. Tobi, P.B. Van den Berg, J. Buiskool, L. Wagenaar, R.B. Minderaa, et al.
Use of antipsychotic drugs among Dutch youths between 1997 and 2005.
Psychiatr Serv, 59 (2008), pp. 554-560
[8.]
L. Sikich, J.A. Frazier, J. McClellan, R.L. Findling, B. Vitiello, L. Ritz, et al.
Double-blind comparison of first- and second-generation antipsychotics in early-onset schizophrenia and schizo-affective disorder: findings from the treatment of early-onset schizophrenia spectrum disorders (TEOSS) study.
Am J Psychiatry, 165 (2008), pp. 1420-1431
[9.]
C.U. Correll.
Antipsychotic use in children and adolescents: minimizing adverse effects to maximize outcomes.
J Am Acad Child Adolesc Psychiatry, 47 (2008), pp. 9-20
[10.]
D. Fraguas, J. Merchán-Naranjo, P. Laita, M. Parellada, D. Moreno, A. Ruiz-Sancho, et al.
Metabolic and hormonal side effects in children and adolescents treated with second-generation antipsychotics.
J Clin Psychiatry, 69 (2008), pp. 1166-1175
[11.]
P. Tyrer, T. Kendall.
The spurious advance of antipsychotic drug therapy.
Lancet, 373 (2009), pp. 4-5
[12.]
C.U. Correll, H.E. Carlson.
Endocrine and metabolic adverse effects of psychotropic medications in children and adolescents.
J Am Acad Child Adolesc Psychiatry, 45 (2006), pp. 771-791
[13.]
C.U. Correll, P. Manu, V. Olshanskiy, B. Napolitano, J.M. Kane, A.K. Malhotra.
Cardiometabolic risk of second-generation antipsychotic medications during first-time use in children and adolescents.
JAMA, 302 (2009), pp. 1765-1773
[14.]
R. Weiss, J. Dziura, T.S. Burgert, W.V. Tamborlane, S.E. Taksali, C.W. Yeckel, et al.
Obesity and the metabolic syndrome in children and adolescents.
N Engl J Med, 350 (2004), pp. 2362-2374
[15.]
D. Fraguas, M.J. de Castro, O. Medina, M. Parellada, D. Moreno, M. Graell, et al.
Does diagnostic classification of early-onset psychosis change over follow-up?.
Child Psychiatry Hum Dev, 39 (2008), pp. 137-145
[16.]
R.L. Findling, A. Robb, M. Nyilas, R.A. Forbes, N. Jin, S. Ivanova, et al.
A multiple-center, randomized, double-blind, placebo-controlled study of oral aripiprazole for treatment of adolescents with schizophrenia.
Am J Psychiatry, 165 (2008), pp. 1432-1441
[17.]
M. Haas, M. Eerdekens, S. Kushner, J. Singer, I. Augustyns, J. Quiroz, et al.
Efficacy, safety and tolerability of two dosing regimens in adolescent schizophrenia: double-blind study.
Br J Psychiatry, 194 (2009), pp. 158-164
[18.]
L. Kryzhanovskaya, S.C. Schulz, C. McDougle, J. Frazier, R. Dittmann, C. Robertson-Plouch, et al.
Olanzapine versus placebo in adolescents with schizophrenia: a 6-week, randomized, doubleblind, placebo-controlled trial.
J Am Acad Child Adolesc Psychiatry, 48 (2009), pp. 60-70
[19.]
M. Tohen, L. Kryzhanovskaya, G. Carlson, M. Delbello, J. Wozniak, R. Kowatch, et al.
Olanzapine versus placebo in the treatment of adolescents with bipolar mania.
Am J Psychiatry, 164 (2007), pp. 1547-1556
[20.]
S. Kumra, H. Kranzler, G. Gerbino-Rosen, H.M. Kester, C. De Thomas, V. Kafantaris, et al.
Clozapine and “high-dose” olanzapine in refractory early-onset schizophrenia: a 12-week randomized and double-blind comparison.
Biol Psychiatry, 63 (2008), pp. 524-529
[21.]
S. Kumra, J.V. Oberstar, L. Sikich, R.L. Findling, J.M. McClellan, S. Vinogradov, et al.
Efficacy and tolerability of secondgeneration antipsychotics in children and adolescents with schizophrenia.
Schizophr Bull, 34 (2008), pp. 60-71
[22.]
P. Shaw, A. Sporn, N. Gogtay, G.P. Overman, D. Greenstein, P. Gochman, et al.
Childhood-onset schizophrenia: A double-blind, randomized clozapine-olanzapine comparison.
Arch Gen Psychiatry, 63 (2006), pp. 721-730
[23.]
C. Arango, O. Robles, M. Parellada, D. Fraguas, A. Ruiz-Sancho, O. Medina, et al.
Olanzapine compared to quetiapine in adolescents with a first psychotic episode.
Eur Child Adolesc Psychiatry, 18 (2009), pp. 418-428
[24.]
J. Castro-Fornieles, M. Parellada, C.A. Soutullo, I. Baeza, A. González-Pinto, M. Graell, et al.
Antipsychotic treatment in child and adolescent first-episode psychosis: a longitudinal naturalistic approach.
J Child Adolesc Psychopharmacol, 18 (2008), pp. 327-336
[25.]
D. Gothelf, A. Apter, J. Reidman, A. Brand-Gothelf, Y. Bloch, G. Gal, et al.
Olanzapine, risperidone and haloperidol in the treatment of adolescent patients with schizophrenia.
J Neural Transm, 110 (2003), pp. 545-560
[26.]
L. Sikich, R.M. Hamer, R.A. Bashford, B.B. Sheitman, J.A. Lieberman.
A pilot study of risperidone, olanzapine, and haloperidol in psychotic youth: a double-blind, randomized, 8-week trial.
Neuropsychopharmacology, 29 (2004), pp. 133-145
[27.]
C. Fleischhaker, P. Heiser, K. Hennighausen, B. Herpertz-Dahlmann, K. Holtkamp, C. Mehler-Wex, et al.
Weight gain associated with clozapine, olanzapine and risperidone in children and adolescents.
J Neural Transm, 114 (2007), pp. 273-280
[28.]
C. Fleischhaker, P. Heiser, K. Hennighausen, B. Herpertz-Dahlmann, K. Holtkamp, C. Mehler-Wex, et al.
Weight gain in children and adolescents during 45 weeks treatment with clozapine, olanzapine and risperidone.
J Neural Transm, 115 (2008), pp. 1599-1608
[29.]
V.J. Fedorowicz, E. Fombonne.
Metabolic side effects of atypical antipsychotics in children: a literature review.
J Psychopharmacol, 19 (2005), pp. 533-550
[30.]
K.A. Stigler, M.N. Potenza, C.J. McDougle.
Tolerability profile of atypical antipsychotics in children and adolescents.
Paediatr Drugs, 3 (2001), pp. 927-942
[31.]
W.V. Vieweg, A.B. Sood, A. Pandurangi, J.J. Silverman.
Newer antipsychotic drugs and obesity in children and adolescents How should we assess drug-associated weight gain?.
Acta Psychiatr Scand, 111 (2005), pp. 177-184
[32.]
Y. Roke, P.N. Van Harten, A.M. Boot, J.K. Buitelaar.
Antipsychotic medication in children and adolescents: a descriptive review of the effects on prolactin level and associated side effects.
J Child Adolesc Psychopharmacol, 19 (2009), pp. 403-414
[33.]
M. Pappagallo, R. Silva.
The effect of atypical antipsychotic agents on prolactin levels in children and adolescents.
J Child Adolesc Psychopharmacol, 14 (2004), pp. 359-371
[34.]
M.A. Richardson, G. Haugland, T.J. Craig.
Neuroleptic use, parkinsonian symptoms, tardive dyskinesia, and associated factors in child and adolescent psychiatric patients.
Am J Psychiatry, 148 (1991), pp. 1322-1328
[35.]
J. Cheng-Shannon, J.J. McGough, C. Pataki, J.T. McCracken.
Secondgeneration antipsychotic medications in children and adolescents.
J Child Adolesc Psychopharmacol, 14 (2004), pp. 372-394
[36.]
I.D. Glick, S.R. Murray, P. Vasudevan, S.R. Marder, R.J. Hu.
Treatment with atypical antipsychotics: new indications and new populations.
J Psychiatr Res, 35 (2001), pp. 187-191
[37.]
P.S. Jensen, J. Buitelaar, G.J. Pandina, C. Binder, M. Haas.
Management of psychiatric disorders in children and adolescents with atypical antipsychotics: a systematic review of published clinical trials.
Eur Child Adolesc Psychiatry, 16 (2007), pp. 104-120
[38.]
C.U. Correll, J.M. Kane.
One-year incidence rates of tardive dyskinesia in children and adolescents treated with secondgeneration antipsychotics: a systematic review.
J Child Adolesc Psychopharmacol, 17 (2007), pp. 647-656
[39.]
P. Toren, S. Ratner, N. Laor, A. Weizman.
Benefit-risk assessment of atypical antipsychotics in the treatment of schizophrenia and comorbid disorders in children and adolescents.
Drug Saf, 27 (2004), pp. 1135-1156
[40.]
R.S. McIntyre, J.M. Jerrell.
Metabolic and cardiovascular adverse events associated with antipsychotic treatment in children and adolescents.
Arch Pediatr Adolesc Med, 162 (2008), pp. 929-935
[41.]
M. Harrison-Woolrych, J. Garcia-Quiroga, J. Ashton, P. Herbison.
Safety and usage of atypical antipsychotic medicines in children: a nationwide prospective cohort study.
Drug Saf, 30 (2007), pp. 569-579
[42.]
C.U. Correll, E.M. Sheridan, M.P. DelBello.
Antipsychotic and mood stabilizer efficacy and tolerability in pediatric and adult patients with bipolar I mania: a comparative analysis of acute, randomized, placebo-controlled trials.
Bipolar Disord, 12 (2010), pp. 116-141
[43.]
M.K. Singh, T.A. Ketter, K.D. Chang.
Atypical antipsychotics for acute manic and mixed episodes in children and adolescents with bipolar disorder: efficacy and tolerability.
Drugs, 70 (2010), pp. 433-442
[44.]
M.P. DelBello, C.U. Correll.
Primum non nocere: balancing the risks and benefits of prescribing psychotropic medications for youth with bipolar disorder.
Bipolar Disord, 12 (2010), pp. 113-115
[45.]
R.L. Findling, N.K. McNamara.
Atypical antipsychotics in the treatment of children and adolescents: clinical applications.
J Clin Psychiatry, 65 (2004), pp. 30-44
[46.]
S. Leucht, C. Corves, D. Arbter, R.R. Engel, C. Li, J.M. Davis.
Secondgeneration versus first-generation antipsychotic drugs for schizophrenia: a meta-analysis.
Lancet, 373 (2009), pp. 31-41
[47.]
V. Burke.
Obesity in childhood and cardiovascular risk.
Clin Exp Pharmacol Physiol, 33 (2006), pp. 831-837
[48.]
S.M. Stahl, L. Mignon, J.M. Meyer.
Which comes first: atypical antipsychotic treatment or cardiometabolic risk?.
Acta Psychiatr Scand, 119 (2009), pp. 171-179
[49.]
Moreno CM-NJ, Álvarez M, Baeza I, Alda JA, Martínez-Cantarero C, Parellada M, Sánchez B, De la Serna E, Giráldez M, Arango C. Metabolic effects of second-generation antipsychotics in bipolar youth: comparison with other psychotic and nonpsychotic diagnoses. Bipolar Disroder. En prensa.
[50.]
V. Simon, R. Van Winkel, M. De Hert.
Are weight gain and metabolic side effects of atypical antipsychotics dose dependent? A literature review.
J Clin Psychiatry, 70 (2009), pp. 1041-1050
[51.]
C.L. Alfaro, M. Wudarsky, R. Nicolson, P. Gochman, A. Sporn, M. Lenane, et al.
Correlation of antipsychotic and prolactin concentrations in children and adolescents acutely treated with haloperidol, clozapine, or olanzapine.
J Child Adolesc Psychopharmacol, 12 (2002), pp. 83-91
[52.]
M. Haas, A.S. Unis, J. Armenteros, M.D. Copenhaver, J.A. Quiroz, S.F. Kushner.
A 6-week, randomized, double-blind, placebocontrolled study of the efficacy and safety of risperidone in adolescents with schizophrenia.
J Child Adolesc Psychopharmacol, 19 (2009), pp. 611-621
[53.]
R. Pérez-Iglesias, B. Crespo-Facorro, O. Martínez-García, M.L. Ramírez-Bonilla, M. Álvarez-Jiménez, J.M. Pelayo-Terán, et al.
Weight gain induced by haloperidol, risperidone and olanzapine after 1 year: findings of a randomized clinical trial in a drug-naive population.
Schizophr Res, 99 (2008), pp. 13-22
[54.]
P. Laita, A. Cifuentes, A. Doll, C. Llorente, I. Cortes, M. Parellada, et al.
Antipsychotic-related abnormal involuntary movements and metabolic and endocrine side effects in children and adolescents.
J Child Adolesc Psychopharmacol, 17 (2007), pp. 487-502
[55.]
J.M. Davis, N. Chen, I.D. Glick.
A meta-analysis of the efficacy of second-generation antipsychotics.
Arch Gen Psychiatry, 60 (2003), pp. 553-564
[56.]
S. Leucht, K. Komossa, C. Rummel-Kluge, C. Corves, H. Hunger, F. Schmid, et al.
A meta-analysis of head-to-head comparisons of second-generation antipsychotics in the treatment of schizophrenia.
Am J Psychiatry, 166 (2009), pp. 152-163
[57.]
H. Carmel, J.M. Gorman.
Classifying antipsychotics by likelihood of metabolic side-effects.
Psychiatr Serv, 60 (2009), pp. 1143
[58.]
T.A. Cohn, M.J. Sernyak.
Metabolic monitoring for patients treated with antipsychotic medications.
Can J Psychiatry, 51 (2006), pp. 492-501
[59.]
E.H. Morrato, B. Druss, D.M. Hartung, R.J. Valuck, R. Allen, E. Campagna, et al.
Metabolic testing rates in 3 state Medicaid programs after FDA warnings and ADA/APA recommendations for secondgeneration antipsychotic drugs.
Arch Gen Psychiatry, 67 (2010), pp. 17-24
[60.]
L. Bastiaens.
A non-randomized, open study with aripiprazole and ziprasidone for the treatment of aggressive behavior in youth in a community clinic.
Community Ment Health J, 45 (2009), pp. 73-77
[61.]
M.P. Delbello, M.L. Schwiers, H.L. Rosenberg, S.M. Strakowski.
A double-blind, randomized, placebo-controlled study of quetiapine as adjunctive treatment for adolescent mania.
J Am Acad Child Adolesc Psychiatry, 41 (2002), pp. 1216-1223
[62.]
M.P. DelBello, K. Chang, J.A. Welge, C.M. Adler, M. Rana, M. Howe, et al.
A double-blind, placebo-controlled pilot study of quetiapine for depressed adolescents with bipolar disorder.
Bipolar Disord, 11 (2009), pp. 483-493
[63.]
R.L. Findling, M. Nyilas, R.A. Forbes, R.D. McQuade, N. Jin, T. Iwamoto, et al.
Acute treatment of pediatric bipolar I disorder, manic or mixed episode, with aripiprazole: a randomized, double-blind, placebo-controlled study.
J Clin Psychiatry, 70 (2009), pp. 1441-1451
[64.]
M. Haas, M.P. Delbello, G. Pandina, S. Kushner, I. Van Hove, I. Augustyns, et al.
Risperidone for the treatment of acute mania in children and adolescents with bipolar disorder: a randomized, double-blind, placebo-controlled study.
Bipolar Disord, 11 (2009), pp. 687-700
[65.]
J.B. Jensen, S. Kumra, W. Leitten, J. Oberstar, A. Anjum, T. White, et al.
A comparative pilot study of second-generation antipsychotics in children and adolescents with schizophreniaspectrum disorders.
J Child Adolesc Psychopharmacol, 18 (2008), pp. 317-326
[66.]
S. Kumra, J.A. Frazier, L.K. Jacobsen, K. McKenna, C.T. Gordon, M.C. Lenane, et al.
Childhood-onset schizophrenia. A doubleblind clozapine-haloperidol comparison.
Arch Gen Psychiatry, 53 (1996), pp. 1090-1097
[67.]
T. Mozes, T. Ebert, S.E. Michal, B. Spivak, A. Weizman.
An openlabel randomized comparison of olanzapine versus risperidone in the treatment of childhood-onset schizophrenia.
J Child Adolesc Psychopharmacol, 16 (2006), pp. 393-403
[68.]
H.S. Swadi, B.J. Craig, N.Z. Pirwani, V.C. Black, J.C. Buchan, C.M. Bobier.
A trial of quetiapine compared with risperidone in the treatment of first onset psychosis among 15- to 18-year-old adolescents.
Int Clin Psychopharmacol, 25 (2010), pp. 1-6
[69.]
S. Tramontina, C.P. Zeni, C.R. Ketzer, G.F. Pheula, J. Narvaez, L.A. Rohde.
Aripiprazole in children and adolescents with bipolar disorder comorbid with attention-deficit/hyperactivity disorder: a pilot randomized clinical trial.
J Clin Psychiatry, 70 (2009), pp. 756-764
[70.]
J. Biederman, E. Mick, P. Hammerness, T. Harpold, M. Aleardi, M. Dougherty, et al.
Open-label, 8-week trial of olanzapine and risperidone for the treatment of bipolar disorder in preschoolage children.
Biol Psychiatry, 58 (2005), pp. 589-594
[71.]
C. Fleischhaker, P. Heiser, K. Hennighausen, B. Herpertz-Dahlmann, K. Holtkamp, C. Mehler-Wex, et al.
Clinical drug monitoring in child and adolescent psychiatry: side effects of atypical neuroleptics.
J Child Adolesc Psychopharmacol, 16 (2006), pp. 308-316
[72.]
M. Hrdlicka, I. Zedkova, M. Blatny, T. Urbanek.
Weight gain associated with atypical and typical antipsychotics during treatment of adolescent schizophrenic psychoses: A retrospective study.
Neuro Endocrinol Lett, 30 (2009), pp. 256-261
[73.]
R.A. Khan, L.M. Mican, B.T. Suehs.
Effects of olanzapine and risperidone on metabolic factors in children and adolescents: a retrospective evaluation.
J Psychiatr Pract, 15 (2009), pp. 320-328
[74.]
G. Migliardi, E. Spina, C. D’Arrigo, A. Gagliano, E. Germano, R. Siracusano, et al.
Short- and long-term effects on prolactin of risperidone and olanzapine treatments in children and adolescents.
Prog Neuropsychopharmacol Biol Psychiatry, 33 (2009), pp. 1496-1501
[75.]
G. Ratzoni, D. Gothelf, A. Brand-Gothelf, J. Reidman, L. Kikinzon, G. Gal, et al.
Weight gain associated with olanzapine and risperidone in adolescent patients: a comparative prospective study.
J Am Acad Child Adolesc Psychiatry, 41 (2002), pp. 337-343
[76.]
E. Saito, C.U. Correll, K. Gallelli, M. McMenimun, U.H. Parikh, A.K. Malhotra, et al.
A prospective study of hyperprolactinemia in children and adolescents treated with atypical antipsychotic agents.
J Child Adolesc Psychopharmacol, 14 (2004), pp. 350-358
[77.]
J.R. Stevens, P.I. Kymissis, A.J. Baker.
Elevated prolactin levels in male youths treated with risperidone and quetiapine.
J Child Adolesc Psychopharmacol, 15 (2005), pp. 893-900
[78.]
M. Wudarsky, R. Nicolson, S.D. Hamburger, L. Spechler, P. Gochman, J. Bedwell, et al.
Elevated prolactin in pediatric patients on typical and atypical antipsychotics.
J Child Adolesc Psychopharmacol, 9 (1999), pp. 239-245
[79.]
W. Guy.
ECDEU Assessment Manual for Psychopharmacology edición revisada.
US Department of Health, Education, and Welfare, (1976),
[80.]
T.R. Barnes.
The Barnes Akathisia Rating Scale--revisited.
J Psychopharmacol, 17 (2003), pp. 365-370
[81.]
G.M. Simpson, J.W. Angus.
A rating scale for extrapyramidal side effects.
Acta Psychiatr Scand Suppl, 212 (1970), pp. 11-19
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