Overdoses and Ingestions of Second-Generation Antipsychotics in Children and Adolescents

2005 ◽  
Vol 15 (6) ◽  
pp. 970-985 ◽  
Author(s):  
Smita X. Antia ◽  
Ellen H. Sholevar ◽  
David A. Baron
Keyword(s):  
Children And Adolescents ◽  
Second Generation ◽  
Second Generation Antipsychotics

scholarly journals Patient, Treatment, and Health Care Utilization Variables Associated with Adherence to Metabolic Monitoring Practices in Children and Adolescents Taking Second-Generation Antipsychotics

2018 ◽  
Vol 63 (4) ◽  
pp. 240-249 ◽  
Author(s):  
Mary Coughlin ◽  
Catherine Lindsay Goldie ◽  
Joan Tranmer ◽  
Sarosh Khalid-Khan ◽  
Deborah Tregunno
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Children And Adolescents ◽  
Second Generation ◽  
Retrospective Chart Review ◽  
Patient Treatment ◽  
Care Utilization ◽  
Metabolic Monitoring ◽  
Second Generation Antipsychotics ◽  
Outpatient Psychiatry

Objective: Children and adolescents with a range of psychiatric disorders are increasingly being prescribed atypical or second-generation antipsychotics (SGAs). While SGAs are effective at treating conduct and behavioural symptoms, they infer significant cardiometabolic risk. This study aims to explore what patient, treatment, and health care utilization variables are associated with adherence to Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotics in Children (CAMESA) metabolic monitoring guidelines. Method: A retrospective chart review of 294 children and adolescents accessing a large outpatient psychiatry setting within a 2-year study period (2014-2016) was conducted. Baseline and follow-up metabolic monitoring, demographic, treatment, and health care utilization variables were then assessed over a 1-year period of interest. Results: Metabolic monitoring practices did not adhere to CAMESA guidelines and were very poor over the 1-year observation period. There were significant differences between children (ages 4-12 years, n = 99) and adolescents (ages 13-18 years, n = 195). In adolescents, factors associated with any baseline metabolic monitoring were a higher number of psychiatry visits (odds ratio [OR], 1.2; 95% confidence interval [CI], 1.10 to 1.41), longer duration of contact (OR, 14; 95% CI, 2.31 to 82.4), and use of other non-SGA medications (OR, 3.2; 95% CI, 1.17 to 8.94). Among children, having an emergency room visit (OR, 3.4; 95% CI, 1.01 to 11.71) and taking aripiprazole (OR, 7.4; 95% CI, 2.02 to 27.45) increased the odds of receiving baseline metabolic monitoring. Conclusion: Findings from this study highlight the need for better metabolic monitoring for children and adolescents taking SGAs. Enhanced focus on opportunities for multidisciplinary collaboration is needed to improve the quality of care offered to this population.

Adverse Effects of Second-Generation Antipsychotics in Children and Adolescents

2012 ◽  
Vol 32 (3) ◽  
pp. 309-316 ◽  
Author(s):  
David Cohen ◽  
Olivier Bonnot ◽  
Nicolas Bodeau ◽  
Angèle Consoli ◽  
Claudine Laurent
Keyword(s):  
Adverse Effects ◽  
Children And Adolescents ◽  
Second Generation ◽  
Second Generation Antipsychotics

scholarly journals Using marginal structural models to identify the cardiovascular adverse effects of second generation antipsychotics in children and adolescents

2015 ◽  
Vol 1 (1) ◽  
pp. 5
Author(s):  
Avnish Tripathi ◽  
George B. Black ◽  
Jeanette M. Jerrell
Keyword(s):  
South Carolina ◽  
Children And Adolescents ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Second Generation ◽  
Structural Models ◽  
Marginal Structural Models ◽  
Data Set ◽  
Pharmacy Claims ◽  
Increased Risk ◽  
Second Generation Antipsychotics

In pediatric patients, we examined the association between exposure to five second generation antipsychotics (SGAs) and incidentcardiovascular events (arrhythmic or ischemic/myocardial) over time using marginal structural models (MSM), while controllingfor salient comorbid conditions and co-prescribed psychotropic medications. A retrospective cohort, longitudinal/ observationalstudy design was used to evaluate Medicaid medical and pharmacy claims in 4140 children and adolescents prescribed SGAsfrom South Carolina USA’s Medicaid program covering outpatient and inpatient medical services and medication prescriptionsbetween January, 1996 and December, 2005. Exposure to multiple SGAs (Risk Ratio [RR]=2.37; 95% CI=1.17-4.83), coprescribedpsychostimulants (RR=1.37; CI=1.03-1.81), and comorbid hypertension (RR=2.23; CI=1.28-3.89) were associatedwith a significantly increased risk of arrhythmias compared to those not exposed, whereas exposure to co-prescribed serotoninnorepinephrine reuptake inhibitor/heterocyclic compounds was associated with a significantly decreased risk of arrhythmias(RR=0.59; CI=0.35-0.99). The risk of incident ischemic/myocardial events was significantly associated with the co-prescription ofmood stabilizers (RR=1.68; CI=1.06-2.68) or selective serotonin reuptake inhibitors (RR=1.91; CI=1.18-3.09), and the presenceof comorbid hypertension (RR=3.97; CI=1.96-8.07) and obesity (RR=2.21; CI=1.34-3.67). MSM analyses comparing multipletreatments while controlling for confounding variables in an observational, longitudinal data set provide important, differentialestimates of outcome, when randomized, controlled trials estimating low-incidence outcomes such as cardiovascular adverseevents in large pediatric patient populations are not feasible.

Enhancing metabolic monitoring for children and adolescents using second-generation antipsychotics

2017 ◽  
Vol 27 (3) ◽  
pp. 1188-1198 ◽  
Author(s):  
Mary Coughlin ◽  
Catherine L. Goldie ◽  
Deborah Tregunno ◽  
Joan Tranmer ◽  
Marina Kanellos-Sutton ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Second Generation ◽  
Metabolic Monitoring ◽  
Second Generation Antipsychotics
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