Antipsychotics Increase Adiposity, Insulin Resistance in Children

We know from a variety of

studies in adults using atypical antipsychotics that there is a range of

potential weight gain seen with this class of agents. With these agents also

being used in children for major mental health concerns, it’s important to have

information from studies like Dr. Newcomer’s on the metabolic effects in that

age group.

The challenge is finding

the balance between selecting the agent that works best for the child and

monitoring very carefully for things like rapid weight gain, higher blood

glucose values, and issues that may be associated with these metabolic

disturbances such as high levels of triglycerides or increases in appetite.

Dr. David M. Kendall

Weight gain is part and

parcel of our environment, and in many cases is attributed to the availability

of calorie-dense foods and decreased physical activity. If we have medications

that add to that, in this case the atypical antipsychotics, we have to be judicious

about using these medications. Clinicians need to be very attentive, both the

in specialty setting and the primary care setting, to watch for changes such as

rapid weight gain, and then offer alternative therapies if they are available.

As we’ve learned with

adults, anyone who is considering prescribing this class of medications should

carefully monitor body weight, plasma glucose (an obvious measure of changing

glucose tolerance), and other associated risk factors like blood pressure and

blood lipids, which can change as adiposity changes. I think it would be

critical to monitor all of those in a situation like this.

Dr.

David M. Kendall is chief scientific and medical officer for the

American Diabetes Association, Alexandria, Va. He said he has no relevant

conflicts of interest.