Pediatric Use of Antipsychotics Linked to Metabolic and Cardiovascular Events

Pediatric Use of Antipsychotics Linked to Metabolic and Cardiovascular Events

Over the last 10 years we have seen a huge increase in the use of antipsychotic medication for our children, despite adequate safety studies (if your autistic child is on any antipsychotic drug other than Risperdal, they are being used off-label and not approved). Many physicians are blindly prescribing these medications without proper training or even monitoring the child for side effects. Frequently I have patients come into my office desiring to withdrawal from these medications due to the intolerable side effects, but the conventional medical system still clings to them as the only source of help. Lack of studies showing negative side effects have given them clout to continue prescribing.

No longer can this occur though as a recent study published in the Archives of Pediatric and Adolescent Medicine showed the horrible effects these drugs can have on our children. This study gathered health data from 1996 to 2005 of 4140 children and adolescents prescribed 1 to 5 atypical or 2 conventional antipsychotics. They then compared this to a control group of children not on these medications.

Compared to the control sample the children on antipsychotics had a higher prevalence of obesity, type 2 diabetes mellitus, heart arrhythmias (irregular heartbeats) and orthostatic hypotension (low blood pressure when rising from sitting/laying to standing). Alarmingly the risk for obesity was doubled and the risk for type 2 diabetes tripled!

The authors also noted that by the end of the study 25% of the children on antipsychotics had 1 to 3 metabolic diseases along with their psychiatric disorders meaning that in 1/4th of the children being treated the drugs caused additional diseases instead of solving the psychiatric illness they were "supposed" to manage.

Could this be a contributing cause of the rise in childhood diabetes and obesity? Either way the data in my opinion should scare any parent away from these medications as the first line therapy and reserve them as the last choice when all other therapies have failed.

Are there other options YES!!! That is the whole basis of what I do, first treating the cause of these illnesses before using strong medications that merely manage the symptoms. Here is an analogy. If your child is sitting on a tack, the way to stop the pain is removing the tack, not simply giving a pain reliever. That is what we do, my whole job and focus is to find those tacks in your child and remove them. It can be done. I will do it.

References:

Arch Pediatr Adolesc Med. 2008;162

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