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Widely used anti-psychotic medications for troubled kids and teens can trigger weight gain and decrease insulin sensitivity, putting them at increased risk for diabetes, according to a new study.
Non-psychotic disorders
Anti-psychotic medications are used in youngsters to treat non-psychotic disorders associated with disruptive behaviour, such as attention deficit hyperactivity disorder (ADHD), the researchers noted.
It was known that these drugs increase the risk for diabetes, but how they did so was unclear.
"Over the past two decades, the US has seen a dramatic increase in the use of anti-psychotic medications in children... part of a national phenomenon where children who have non-psychotic disorders with disruptive behaviours are increasingly being treated with anti-psychotic medications," said study senior author Dr John Newcomer. He's a psychiatrist and professor of integrated medical science at Florida Atlantic University.
The study was published in the journal JAMA Psychiatry.
According to the Attention Deficit and Hyperactivity Support Group of Southern Africa (ADHASA), 10% of the South African population suffer from ADD and ADHD.
The study
This study included 144 children and adolescents, ages six to 18, with at least one psychiatric disorder involving significant aggression, who were already being considered for treatment with anti-psychotic medications. They received 12 weeks of treatment with one of three anti-psychotics: oral aripiprazole (Abilify), olanzapine (Zyprexa) or risperidone (Risperdal).
The researchers then measured changes in whole body and abdominal fat as well as insulin sensitivity and found significant increases in body fat in all the patients, most particularly those who were given olanzapine.
There were also increases in visceral and subcutaneous abdominal fat. Such increases have been associated with long-term risk for cardiovascular disease, high blood pressure and type 2 diabetes, the researchers noted.
Risk-benefit considerations
"There was certainly reason to worry about the metabolic risks of using anti-psychotic medications in children, and that prompted us to do this study," Newcomer said in a university news release.
Study first author Dr Ginger Nicol is an associate professor of psychiatry at Washington University in St. Louis.
"While anti-psychotic medications are first-line treatments for conditions like paediatric-onset schizophrenia, bipolar disorder and autism, it is imperative for psychiatrists treating children – especially for off-label conditions where less safety data is available – to carefully evaluate risk-benefit considerations," Nicol said in the release.
"And if we do treat children with anti-psychotics, we have to be diligent in monitoring body weight as well as blood sugar, cholesterol and triglyceride levels and then be prepared to change course if we see adverse medication effects that could increase long-term risk for diabetes, cardiovascular disease and other conditions," she added.
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