Journal article
Cardiometabolic Outcomes in Children and Adolescents Following Discontinuation of Long-Term Risperidone Treatment
Journal of child and adolescent psychopharmacology, Vol.24(3), pp.12-129
04/01/2014
DOI: 10.1089/cap.2013.0126
PMCID: PMC3993060
PMID: 24725198
Abstract
Objective:
Second-generation antipsychotics (SGAs) cause weight gain and cardiometabolic abnormalities in children and adolescents. Less well-investigated is the outcome of these adverse events following SGA discontinuation, which we examined.
Methods:
Medically healthy 7 to 17-year-old patients treated with risperidone for ≥6 months were enrolled and returned for follow-up, 1.5 years later. Treatment history was extracted from the medical and pharmacy records. Anthropometric and laboratory measurements were obtained at each research visit. Multivariable linear regression analysis and Fisher's exact test were used to compare participants who remained on risperidone at follow-up (Risp Cont Group) with those who had discontinued SGA treatment (SGA Disc Group) and those who had switched to another SGA (SGA Cont Group). Correlational analyses examined the association between change in age-sex specific body mass index (BMI) z score between study entry and follow-up and change in cardiometabolic outcomes.
Results:
The sample consisted of 101 participants (93% male) with a mean age of 11.7±2.6 years at study entry. The majority had an externalizing disorder and received 0.03±0.02 mg/kg/day of risperidone, for 2.5±1.6 years. At follow-up, 18% (
n
=18) were in the SGA Disc Group and 9% (
n
=9) were in the SGA Cont Group. BMI
z
score decreased in the SGA Disc Group, remained unchanged in the Risp Cont Group (
n
=74), and increased in the SGA Cont Group. Importantly, the change in BMI
z
score between study entry and follow-up was significantly correlated with the change in systolic and diastolic blood pressure
z
scores, heart rate, waist circumference, percent body fat, inflammatory markers, fasting total insulin, homeostatic model assessment insulin resistance index (HOMA-IR), C-peptide, total, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol, triglycerides, triglycerides/HDL ratio, and leptin.
Conclusions:
Following several years of treatment, risperidone discontinuation is associated with a reversal of the excessive weight gain, mediated by a negative energy balance, and a corresponding improvement in cardiometabolic parameters.
Details
- Title: Subtitle
- Cardiometabolic Outcomes in Children and Adolescents Following Discontinuation of Long-Term Risperidone Treatment
- Creators
- Chadi A. Calarge - University of IowaGinger Nicol - 2Department of Psychiatry, Washington University School of Medicine, St. Louis, MissouriJanet A. Schlechte - University of IowaTrudy L. Burns - Washington University in St. Louis
- Resource Type
- Journal article
- Publication Details
- Journal of child and adolescent psychopharmacology, Vol.24(3), pp.12-129
- Publisher
- Mary Ann Liebert, Inc
- DOI
- 10.1089/cap.2013.0126
- PMID
- 24725198
- PMCID
- PMC3993060
- ISSN
- 1044-5463
- eISSN
- 1557-8992
- Language
- English
- Date published
- 04/01/2014
- Academic Unit
- Psychiatry; Epidemiology; Fraternal Order of Eagles Diabetes Research Center; Endocrinology and Metabolism; Internal Medicine
- Record Identifier
- 9984364396702771
Metrics
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