Wednesday, October 28, 2009

Atypical antipsychotics cause marked and rapid weight gain in kids

In children and adolescents, the so-called atypical antipsychotic agents lead to a marked and rapid weight gain, researchers said.

In a 12-week observational study of four of the newer drugs, the average weight gain was between 4.4 and 8.5 kilograms (9.7 and 18.7 lbs), depending on the agent, according to Christoph Correll, MD, of Zucker Hillside Hospital in Glen Oaks, N.Y., and Albert Einstein College of Medicine, and colleagues.

On the other hand, metabolic changes were less uniform, Correll and colleagues wrote in the Oct. 28 issue of the Journal of the American Medical Association.

The atypical agents -- also called second-generation antipsychotics -- are thought to be more effective than older drugs, but in a pediatric population, their cardiometabolic effects have not been well studied, the researchers said.

To help fill the gap, they studied 272 patients ages 4 through 18, who had not been previously treated with an antipsychotic drug. The Second-Generation Antipsychotic Treatment Indications, Effectiveness, and Tolerability in Youth (SATIETY) study took place between December 2001 and September 2007 at institutions in the borough of Queens, N.Y.

Patients were treated with aripiprazole (Abilify), olanzapine (Zyprexa), quetiapine (Seroquel), or risperidone (Risperdal) for 12 weeks. The 15 patients who refused to take part or did not adhere to the protocol served as a comparison group.

After a median of 10.8 weeks of treatment, the researchers found that weight increased by:

8.5 kg (18.7 lb) on average among the 45 patients taking olanzapine
6.1 kg (13.4 lb) among the 36 patients on quetiapine
5.3 kg (11.7 lb) among the 135 patients on risperidone
4.4 kg (9.7 lb) among the 41 patients on aripiprazole
0.2 kg (0.4 lb) in the untreated comparison group

All the weight gains were significant, compared with baseline weight, at P<0.001.

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