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Weight Gain Associated with Atypical Antipsychotic Use in Children and Adolescents

Prevalence, Clinical Relevance, and Management

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Abstract

Atypical antipsychotics are increasingly prescribed to children and adolescents with neuropsychiatric disorders. Although their profile of potent antagonism at specific serotonin and dopamine receptors offers certain advantages compared with typical antipsychotics, their use has been associated with various adverse effects, including significant weight gain. This adverse effect is of particular concern in children and adolescents, secondary to the immediate and long-term health risks associated with weight gain, including obesity, diabetes mellitus, and hyperlipidemia. Indeed, from 1963 to 1991, the prevalence of obesity has approximately doubled in youth. Prior to selecting an atypical antipsychotic, a detailed review of the predictors of weight gain is necessary for every child and adolescent. Published data suggest that clozapine and olanzapine are associated with considerable weight gain, whereas risperidone and quetiapine have a moderate risk. Alternatively, ziprasidone and aripiprazole may exhibit a low risk for this adverse effect. Whereas behavioral and pharmacologic measures are available to manage weight gain associated with atypical antipsychotics, research is needed to establish more effective and safe interventions for this adverse effect in children and adolescents.

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Acknowledgements

Dr Stigler has no financial relationship with any company whose products are mentioned in this article, or with manufacturers of competing products. Dr Potenza receives research grant support from Bio-Tie Therapies and Forest Laboratories. Dr Posey receives research grant support from Eli Lilly and Co., Janssen Pharmaceutica, and Repligen Corp. He is a consultant to Eli Lilly and Co., and is a member of the speaker’s bureau of Janssen Pharmaceutica. Dr McDougle receives research grant support from, and is a consultant to, Eli Lilly and Co., Janssen Pharmaceutica, Pfizer, Inc., and Repligen Corp. He is a member of the speaker’s bureau of Janssen Pharmaceutica, Pfizer, Inc., and Bristol-Meyers Squibb Company.

This work was supported in part by a Daniel X. Freedman Psychiatric Research Fellowship Award (Dr Posey), a National Alliance for Research in Schizophrenia and Depression (NARSAD) Young Investigator Award (Dr Posey), a Research Unit on Pediatric Psychopharmacology contract (N01MH70001) from the National Institute of Mental Health to Indiana University (Drs McDougle and Posey), a National Institutes of Health Clinical Research Center grant to Indiana University (M01-RR00750), and a Department of Housing and Urban Development (HUD) grant no. B-01-SP-IN-0200 (Dr McDougle).

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  1. Department of Psychiatry, Indiana University School of Medicine, 1111 W. 10th Street, PB A305, Indianapolis, Indiana, 46202-4800, USA

    Kimberly A. Stigler, David J. Posey &  Christopher J. McDougle

  2. Department of Psychiatry, Yale University School of Medicine, Newhaven, Connecticut, USA

    Marc N. Potenza

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  1. Kimberly A. Stigler
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  2. Marc N. Potenza
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  3. David J. Posey
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  4. Christopher J. McDougle
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Correspondence to Christopher J. McDougle.

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Stigler, K.A., Potenza, M.N., Posey, D.J. et al. Weight Gain Associated with Atypical Antipsychotic Use in Children and Adolescents. Pediatr-Drugs 6, 33–44 (2004). https://doi.org/10.2165/00148581-200406010-00003

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