Safety and tolerability of antipsychotic drugs in pediatric patients
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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