No convincing evidence suggests that atypical antipsychotic medications are superior to typical medications for the treatment of adolescents with psychosis .
However , atypical antipsychotic medications may be more acceptable to young people because fewer symptomatic adverse effects are seen in the short term .
Little evidence is available to support the superiority of one atypical antipsychotic medication over another , but side effect profiles are different for different medications .
Treatment with olanzapine , risperidone and clozapine is often associated with weight gain .
Aripiprazole is not associated with increased prolactin or with dyslipidaemia .
Adolescents may respond better to st and ard-dose as opposed to lower-dose risperidone , but for aripiprazole and ziprasidone , lower doses may be equally effective .
BACKGROUND Schizophrenia often presents in adolescence , but current treatment guidelines are based largely on studies of adults with psychosis .
Over the past decade , the number of studies on treatment of adolescent-onset psychosis has increased .
The current systematic review collates and critiques evidence obtained on the use of various atypical antipsychotic medications for adolescents with psychosis .
OBJECTIVES To investigate the effects of atypical antipsychotic medications in adolescents with psychosis .
We review ed in separate analyses various comparisons of atypical antipsychotic medications with placebo or a typical antipsychotic medication or another atypical antipsychotic medication or the same atypical antipsychotic medication but at a lower dose .
Childhood-onset schizophrenia. A double-blind clozapine-haloperidol comparison.
BACKGROUND Childhood-onset schizophrenia is a rare but severe form of the disorder that is often treatment-refractory . In this study , the efficacy and adverse effects of clozapine and haloperidol were compared for children and adolescents with early-onset schizophrenia . METHODS Twenty-one patients ( mean [ + /-SD ] age , 14.0 + /- 2.3 years ) with onset of Diagnostic and Statistical Manual of Mental Disorders , Revised Third Edition-defined schizophrenia that began by age 12 years and who had been nonresponsive to typical neuroleptics participated in the study . Patients were r and omized to a 6-week double-blind parallel comparison of clozapine ( mean [ + /-SD ] final dose , 176 + /- 149 mg/d ) , or haloperidol , ( 16 + /- 8 mg/d ) . RESULTS Clozapine was superior to haloperidol on all measures of psychosis ( P = .04-.002 ) . Positive and negative symptoms of schizophrenia improved . However , neutropenia and seizures were major concerns . To date , one third of the group has discontinued using clozapine . CONCLUSIONS Clozapine has striking superiority for positive and negative symptoms in treatment-refractory childhood-onset schizophrenia . However , due to possibly increased toxic effects in this pediatric population , close monitoring for adverse events is essential
No convincing evidence suggests that atypical antipsychotic medications are superior to typical medications for the treatment of adolescents with psychosis .
However , atypical antipsychotic medications may be more acceptable to young people because fewer symptomatic adverse effects are seen in the short term .
Little evidence is available to support the superiority of one atypical antipsychotic medication over another , but side effect profiles are different for different medications .
Treatment with olanzapine , risperidone and clozapine is often associated with weight gain .
Aripiprazole is not associated with increased prolactin or with dyslipidaemia .
Adolescents may respond better to st and ard-dose as opposed to lower-dose risperidone , but for aripiprazole and ziprasidone , lower doses may be equally effective .
BACKGROUND Schizophrenia often presents in adolescence , but current treatment guidelines are based largely on studies of adults with psychosis .
Over the past decade , the number of studies on treatment of adolescent-onset psychosis has increased .
The current systematic review collates and critiques evidence obtained on the use of various atypical antipsychotic medications for adolescents with psychosis .
OBJECTIVES To investigate the effects of atypical antipsychotic medications in adolescents with psychosis .
We review ed in separate analyses various comparisons of atypical antipsychotic medications with placebo or a typical antipsychotic medication or another atypical antipsychotic medication or the same atypical antipsychotic medication but at a lower dose .