Safety and tolerability of antipsychotic drugs in pediatric patients

  • Nabih Lawand Psychology Department, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon.
  • Samaa Al Tabbah School of Pharmacy, Lebanese American University, Beirut, Lebanon.
Keywords: Antipsychotics, Pediatric, Safety, Tolerability, FGAs, SGAs, Adolescent, Children


Introduction: Second-generation antipsychotics have seen a significant surge in use for a variety of pediatric psychiatric problems over the last decade, typically as off-label prescriptions. Although they were previously regarded to be safer than older, first-generation antipsychotics, owing to a lower incidence of neurological side effects, current research has raised serious concerns about their metabolic, endocrinological, and cardiovascular side effects.

Methods: The Cochrane Library, PubMed, Embase, and PsychINFO databases were searched for scientific articles between the periods 2009 and 2022. We included studies that reported pediatric patients taking second-generation antipsychotic drugs. The obtained information was evaluated, compiled, analyzed, interpreted, and conclusions were reached

Results: In total, 45 articles were reviewed. The most common and troublesome adverse effects were metabolic, with increasing evidence of a higher risk of type 2 diabetes mellitus. Furthermore, findings showed that different second-generation antipsychotics may have different safety profiles.

Conclusion: In this review, we discussed the safety and tolerability of second-generation antipsychotics in pediatric patients, as well as active monitoring measures that could help pediatricians and child psychiatrists prevent, detect, and manage side effects. The benefits of relieving often severe and debilitating manic, psychotic, and violent symptomatology must be weighed against the various risks of adverse effects associated with individual antipsychotic drugs in pediatric patients when making treatment decisions. Any antipsychotic treatment should begin and end with a consideration of side effects, as well as food and lifestyle advice. Patients and their families should be included in a risk-benefit analysis when considering an antipsychotic treatment. To improve patient outcomes, routine, proactive monitoring of side effects is required.


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Author Biographies

Nabih Lawand, Psychology Department, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon.

Nabih Lawand is a Pre-med psychology student at the American University of Beirut. He is a pre-med student who is currently preparing to join Medical School at the American University of Beirut.
His research interest is generally in clinical research, especially in clinical psychology, Public
health, and General Medicine fields.

Samaa Al Tabbah, School of Pharmacy, Lebanese American University, Beirut, Lebanon.

Dr. Samaa Al Tabbah holds a B.S. in Medical Laboratory Technology from the American University of Beirut and a PharmD in Clinical Pharmacy from the Lebanese American University. She is currently the co-founder and CEO of the Medical Agency for Research and Statistics (MARS). After graduation, she held a position as a chief pharmacist at the World Health Organization (WHO), Beirut office. Through her work, she has been involved in research projects and training workshops carried out at the national and regional level. She is the author of many scientific papers published in peer-reviewed journals as well as a booklet titled “The Clinical Research Process from Initiation to Publication”. She is an editorial member of two peer-reviewed scientific journals and an Assistant Professor at the Lebanese Red University Institute for Nursing. She was lately appointed as the Global Pharmacovigilance Society Ambassador of Lebanon where she also acts as an acting board member of the society. 


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How to Cite
Lawand N, Al Tabbah S. Safety and tolerability of antipsychotic drugs in pediatric patients. jpadr [Internet]. 2022Jun.1 [cited 2024Jul.23];3(2):4-10. Available from: