P-263 - Use of atypical antipsychotics in children with schizophrenia spectrum disorders in Latvia - 13/06/12
Résumé |
Introduction |
In recent years we’ve witnessed a rapid rise in the off-label use of atypical antipsychotics (AAPs) in child and adolescent psychiatry practice despite still limited evidence base for their efficacy and safety.
Aims |
To investigate the patterns of use and frequency of side effects of AAP therapy in children and adolescents with psychotic disorders in Latvia.
Methods |
Retrospective chart review of all inpatients with schizophrenia spectrum disorder diagnosis, treated in Children’s Clinical University Hospital, Riga, Latvia from September 2008 till September 2011.
Results |
We identified 126 admissions (F/M ratio - 1,5; mean age - 13,83 (SD 2,69) years), 32 being first-admissions. Most frequent diagnoses were juvenile-onset (34,1%) and paranoid (23.8%) schizophrenia. In 91,3% cases patients received antipsychotic therapy (28,6% only AAPs, 11,9% only typical antipsychotics (TAPs), 50,8% a combination of both). Most widely used AAPs were Quetiapine - 34,9%, Risperidone - 26,2%, Olanzapine - 19,8% and Aripiprazole - 15,9%. Haloperidol was still used in 49,2% cases. In 58,7% cases patients also received anticholinergic medication, so reports of extrapyramidal side effects were anecdotal. In 31,0% cases (9 patients on AAPs, 30 on combined treatment) there was a significant (>400mU/L) increase of serum prolactin level. In 15,9% cases there was a significant (>450ms) elongation of QTc interval.
Conclusions |
AAPs are rapidly substituting TAPs as the firsthand treatment for children with schizophrenic psychoses, but the rate of side effects is significant, with as much as 1/3 of those receiving AAPs developing hyperprolactinaemia, and 1/5 - a prolongation of QTc interval.
Le texte complet de cet article est disponible en PDF.Vol 27 - N° S1
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