Jennifer C. Seida, M.P.H., from the University of Alberta in Edmonton, Canada, and colleagues reviewed available literature on the safety and effectiveness of first- and second-generation antipsychotics (FGA and SGA) for patients aged 24 years or younger with psychiatric or behavioral conditions. Sixty-four trials and 17 cohort studies were included in the analyses.
The researchers found that most of the trials had a high risk of bias, and the cohort studies were of moderate quality. There was low or insufficient strength of evidence for all comparisons of FGAs versus FGAs, FGAs versus SGAs, or FGAs versus placebo. There was evidence of moderate strength for some SGAs versus SGAs or SGAs versus placebo comparisons. Olanzapine caused more dyslipidemia and weight gain than risperidone, but fewer prolactin-related events. Compared with quetiapine, olanzapine caused more weight gain. Compared with placebo, SGAs improved clinical global impressions in schizophrenia, bipolar, and disruptive behavior disorders; diminished positive and negative symptoms in schizophrenia; diminished behavior symptoms in disruptive behavior disorders; and decreased tics in Tourette syndrome.
"The evidence on the comparative benefits and harms of antipsychotics within and across classes is limited. Some SGAs have a better side effect profile than other SGAs," the authors write.
Abstract
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