Endocrine and Metabolic Adverse Effects of Psychotropic Medications in Children and Adolescents

• NCJ Number: 215079
• Journal: Journal of the American Academy of Child & Adolescent Psychiatry Volume: 45 Issue: 7 Dated: July 2006 Pages: 771-791
• Author(s): Christoph U. Correll M.D.; Harold E. Carlson M.D.
• Date Published: July 2006
• Length: 21 pages
• Grant Number(s): MH 074543-01; MO1RR18535
• Sponsoring Agency: National Institute of Mental Health; North Shore-Long Island Jewish Research Institute; Zucker Hillside Hospital
• Publication Format: Article
• Publication Type: Report (Study/Research); Literature Review
• Language: English
• Country: United States of America

Annotation

This literature review examined studies of the endocrine and metabolic side effects of psychotropic medications, with a focus on studies and case reports that included children and/or adolescents.

Abstract

The studies indicate that psychotropic agents are being used to treat multiple disorders, such as attention-deficit/hyperactivity disorder, mood and anxiety disorders, externalizing disorders, and psychotic disorders. During the last decade, psychotropic medications have been prescribed in increasing amounts for children, including preschoolers, and adolescents; however, research evidence regarding their safety and effectiveness in children and youth is limited. Generally, this literature review advises that normal adult values for the drugs must be adjusted to account for age-appropriate and gender-appropriate developmental changes. Lipid thresholds should be adjusted and percentile cutoffs should be used for waist circumference and blood pressure measurements. Clinicians should monitor the potential for thyroid dysfunction and weight gain with lithium; PCOS, weight gain, and insulin resistance with valproate; and hyperprolactinemia, weight gain, and all components of the metabolic syndrome with atypical antipsychotics. In presenting the findings of the existing research, this article first reports on the effects on thyroid function of the psychotropic drugs of lithium, valproate, and quetiapine. This is followed by a review of research findings regarding effects on parathyroid function of lithium. Other findings pertain to the effects of psychotropic drugs on antidiuretic hormone secretion, the effects on growth of psychostimulants, the effects of antipsychotics on Prl levels, and the effects of antipsychotics and mood stabilizers on weight and the polycystic ovary syndrome (PCOS). For each of the side effects discussed, suggestions are offered for managing the selection of drugs and dosages in order to reduce the detrimental side effects on health and growth. 5 tables and 215 references