Children on Antipsychotics May Have Increased Weight Gain Risk

Children who exhibit severe defiant and disobedient behavior that are treated with antipsychotics may have an increased risk of gaining weight as well as developing insulin resistance and other related conditions, a new study suggests.

Although antipsychotics are primarily used to treat conditions like pediatric-onset schizophrenia, they are also commonly used off-label to treat ADHD (attention deficit/hyperactivity disorder) and disruptive behavior disorders.

For about 4 years, researchers examined 144 children between the ages of 6 and 18 who had disruptive behavior disorders. Around 56% of the kids had a primary diagnosis of ADHD with irritability and aggression that was “insufficiently responsive to prior therapy.” During this randomized clinical trial, the children were treated with antipsychotics for 12 weeks and received oral Abilify (aripiprazole), Zyprexa (olanzapine) or Risperdal (risperidone).

The results, published in JAMA Psychiatry, found that children who were treated with antipsychotics for the first time experienced clinically significant increases in body fat over the course of 12 weeks. Total body fat increased by 1.18% for children taking Risperdal, 1.66% for Abilify and 4.12% for those taking Zyprexa.

Reductions in insulin sensitivity — leading to an increase in blood sugar levels — were also observed during the study.

“Adverse changes in adiposity and insulin sensitivity were observed during 12 weeks of antipsychotic treatment in youths, with the greatest fat increases on olanzapine. Such changes, likely attributable to treatment, may be associated with risk for premature cardiometabolic morbidity and mortality,” researchers said.

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