Endocrine Abstracts

Introduction: Although for the last 2 decades we have witnessed a rise in the use of second generation antipsychotic treatment in children and adolescents suffering from psychiatric disorders we do not have enough studies in specialty literature to estimate the risks associated with this medication. Recent data and also our clinical experience shows that second generation antipsychotic drugs administration correlates with considerable weight gain and also with altering of glucide, lipide and other metabolic markers. The utility of antipsychotic treatment in psychotic disorders and schizophrenia is well known. But does it outweigh the risks? Studies that evaluate the risk/benefit ratio of antipsychotic treatment in early-onset and very-early-onset schizophrenia are much needed.

Design/methods: In the study there were included 19 adolescents aged 12–17 years old who were diagnosed with early-onset and very-early-onset schizophrenia according to DSM-IV criteria and KIDDIE-SADS scales. These patients were treated with risperidone 2–4 mg/day for schizophrenia and trihexiphenidinum (2–4 mg/day) for extrapiramidal sindrome prophilaxy. The following metabolic parameters were followed at baseline, 8 weeks and 6 months: fasting glucose, insuline, cholesterole: HDL, LDL, and plasma trigliceige concentration, hepatic markers: ALT and AST as well as TSH and weight.

Results: At 8 weeks there were no consistent modifications in weight or metabolic parameters but at the 6 months measurement 58% of the patients had gained more than 5kg and there could be observed slight elevations in plasma trigliceride concentration and cholesterole levels.

Conclusions: The small number of patients is for clear a limitation, therefore we find that studies on bigger populations are necessary. Nevertheless this results show the need for an multidisciplinary – psychiatrist, endocrinologist, family doctor – approach of patients undergoing antipsychotic treatment and especially during a period marked by growth and change like adolescence.