CM has served as a consultant for AstraZeneca, Bristol-Myers Squibb, and Otsuka. CA has served as a consultant for AstraZeneca, Bristol-Myers Squibb, Fundación Alicia Koplowitz, Fundación Marcelino Botín, Janssen, Pfizer, Schering-Plough, Servier, the Spanish Ministry of Health, and the Spanish Ministry of Science and Innovation. JM-N, MÁ, IB, JAA, CM-C, MP, BS, EdlS, and MG have no conflicts to disclose.
Metabolic effects of second-generation antipsychotics in bipolar youth: comparison with other psychotic and nonpsychotic diagnoses
Version of Record online: 25 MAR 2010
© 2010 The Authors. Journal compilation © 2010 John Wiley & Sons A/S
Volume 12, Issue 2, pages 172–184, March 2010
How to Cite
Moreno, C., Merchán-Naranjo, J., Álvarez, M., Baeza, I., Alda, J. A., Martínez-Cantarero, C., Parellada, M., Sánchez, B., De La Serna, E., Giráldez, M. and Arango, C. (2010), Metabolic effects of second-generation antipsychotics in bipolar youth: comparison with other psychotic and nonpsychotic diagnoses. Bipolar Disorders, 12: 172–184. doi: 10.1111/j.1399-5618.2010.00797.x
- Issue online: 25 MAR 2010
- Version of Record online: 25 MAR 2010
- Received 24 December 2008, revised and accepted for publication 15 September 2009
- bipolar disorder;
- body mass index;
- psychotic disorder;
- second-generation antipsychotics;
- weight gain
Moreno C, Merchán-Naranjo J, Álvarez M, Baeza I, Alda JA, Martínez-Cantarero C, Parellada M, Sánchez B, de la Serna E, Giráldez M, Arango C. Metabolic effects of second-generation antipsychotics in bipolar youth: comparison with other psychotic and nonpsychotic diagnoses. Bipolar Disord 2010: 12: 172–184. © 2010 The Authors. Journal compilation © 2010 John Wiley & Sons A/S.
Objectives: Despite known metabolic effects of second-generation antipsychotics (SGAs) on children and adolescents, comparative effects in youth with different diagnoses remain underreported. We compared differences in metabolic changes three months after starting treatment with SGAs in youth with bipolar disorder and with other psychotic and nonpsychotic disorders.
Methods: Weight and metabolic differences among diagnostic groups before and three months after starting treatment with SGAs were compared in a naturalistic cohort of children and adolescents (14.9 ± 3.0 years) diagnosed with bipolar disorder (n = 31), other psychotic disorders (n = 29), and other nonpsychotic disorders (n = 30), with no (35.6%) or very little (6.6 ± 9.0 days) previous exposure to antipsychotics. Composite measurements of significant weight gain [weight increase ≥ 5% at three months or increase ≥ 0.5 in body mass index (BMI) z-score] and ‘risk for adverse health outcome’ (≥ 95th BMI percentile, or ≥ 85th BMI percentile plus presence of one other obesity-related complication) were included. SGAs (risperidone, olanzapine, and quetiapine) were prescribed in comparable proportion among groups.
Results: Baseline weight and metabolic indices were not significantly different among diagnoses. Three months after starting treatment with SGAs, more than 70% patients had significant weight gain, BMI z-score increased in all diagnostic groups (p < 0.001 for all comparisons), total cholesterol increased in the bipolar (p = 0.02) and psychotic (p = 0.01) disorder groups, low-density lipoprotein cholesterol increased in the bipolar group (p = 0.02), and free T4 decreased in the psychotic disorder group (p = 0.05). More patients with bipolar disorder presented overweight plus ≥ 1 obesity-related complication at follow-up.
Conclusions: There are early weight gain and metabolic changes across diagnoses in youth treated with SGAs.