Newer antipsychotics no better than older drug in treating child and adolescent schizophrenia

September 15, 2008

Two newer atypical antipsychotic medications were no more effective than an older conventional antipsychotic in treating child and adolescent schizophrenia and may lead to more metabolic side effects, according to a new study funded by the National Institutes of Health's National Institute of Mental Health (NIMH). The study was published online ahead of print September 15, 2008, in the American Journal of Psychiatry.

"Schizophrenia and schizophrenia-related disorders are rare in childhood. But when they do occur, those afflicted generally have more severe symptoms and a worse prognosis than those who develop the disorder in adulthood," said NIMH Director Thomas R. Insel, M.D. "The newer atypical antipsychotics are often used to treat these children, but until now, it has been unclear how effective and safe they really are in children. The side effects of the newer medications should be factored into making treatment decisions."

The six-year, multisite Treatment of Early Onset Schizophrenia Study (TEOSS) included 116 youth between 8 and 19 years old, diagnosed with early onset schizophrenia spectrum disorder (EOSS). The TEOSS team randomly assigned the children to eight weeks of either olanzapine (Zyprexa) or risperidone (Risperdal)—both new generation atypical antipsychotics—or to the older conventional antipsychotic molindone (Moban) plus benztropine, a medication often used to reduce side effects like uncontrolled shaking or tremor that can be associated with molindone. The children were monitored throughout the study by an NIMH oversight board to ensure their safety.

Response rates after eight weeks of treatment were comparable among the three medications—50 percent of the children taking molindone improved, 46 percent taking risperidone improved, and 34 percent taking olanzapine improved. Children taking olanzapine or risperidone improved within the first two weeks, while the children on molindone improved within three weeks.

The treatment groups did differ in side effects. The children taking olanzapine gained about 13 pounds (6 kilograms) during the trial on average, while children taking risperidone gained about 8 pounds (3.6 kilograms), and those taking molindone did not gain weight. The olanzapine group also showed increases in cholesterol levels and other metabolic disruptions that may have become dangerous. The outcome prompted the safety review board to end the olanzapine arm of the study in 2006.

"Atypical antipsychotics are commonly used to treat kids with EOSS, but these results question the wisdom of that approach," said lead author Linmarie Sikich, M.D., of the University of North Carolina at Chapel Hill. "They also remind us that we need to develop safer, more effective medications to treat these children, given the limited effectiveness of both the atypical and the conventional medications."

Study coauthor Jeffery Lieberman, M.D., of Columbia University Medical Center, noted that TEOSS is the first documented evidence of how newer antipsychotics compare to older ones when treating children and adolescents with schizophrenia. "Doctors need to educate families about the potentially serious side effects these drugs can have so that strategies can be put into place to address them," he reiterated. The TEOSS results are similar to those found in the NIMH-funded Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE), for which Lieberman was the principal investigator. CATIE found that the newer antipsychotics were no more effective than an older antipsychotic in treating adults with schizophrenia.

Source: National Institute of Mental Health

Explore further: Antipsychotic drug use in children for mood, behavior disorders increases type 2 diabetes risk

Related Stories

Antipsychotic drug use in children for mood, behavior disorders increases type 2 diabetes risk

August 21, 2013
Prescribing of "atypical" antipsychotic medications to children and young adults with behavioral problems or mood disorders may put them at unnecessary risk for type 2 diabetes, a Vanderbilt University Medical Center study ...

More kids taking antipsychotics for ADHD: study

August 7, 2012
(HealthDay) -- Use of powerful antipsychotic medications such as Abilify and Risperdal to control youngsters with attention-deficit/hyperactivity disorder (ADHD) and other behavior problems has skyrocketed in recent years, ...

Lithium safe, effective for children with bipolar disorder

October 12, 2015
A multicenter study of young patients with bipolar disorder provides what may be the most scientifically rigorous demonstration to date that lithium—a drug used successfully for decades to treat adults with the condition—can ...

Recommended for you

In most surgery patients, length of opioid prescription, number of refills spell highest risk for misuse

January 17, 2018
The possible link between physicians' opioid prescription patterns and subsequent abuse has occupied the attention of a nation in the throes of an opioid crisis looking for ways to stem what experts have dubbed an epidemic. ...

Patients receive most opioids at the doctor's office, not the ER

January 16, 2018
Around the country, state legislatures and hospitals have tightened emergency room prescribing guidelines for opioids to curb the addiction epidemic, but a new USC study shows that approach diverts attention from the main ...

FDA bans use of opioid-containing cough meds by kids

January 12, 2018
(HealthDay)—Trying to put a dent in the ongoing opioid addiction crisis, the U.S. Food and Drug Administration on Thursday slapped strict new restrictions on the use of opioid-containing cold and cough products by kids.

Taking ibuprofen for long periods found to alter human testicular physiology

January 9, 2018
A team of researchers from Denmark and France has found that taking regular doses of the pain reliever ibuprofen over a long period of time can lead to a disorder in men called compensated hypogonadism. In their paper published ...

Nearly one-third of Canadians have used opioids: study

January 9, 2018
Nearly one in three Canadians (29 percent) have used "some form of opioids" in the past five years, according to data released Tuesday as widespread fentanyl overdoses continue to kill.

Growing opioid epidemic forcing more children into foster care

January 8, 2018
The opioid epidemic has become so severe it's considered a national public health emergency. Addiction to prescription painkillers, such as oxycodone and morphine, has contributed to a dramatic rise in overdose deaths and ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.