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 .
Double-blind comparison of first- and second-generation antipsychotics in early-onset schizophrenia and schizo-affective disorder: findings from the treatment of early-onset schizophrenia spectrum disorders (TEOSS) study.
OBJECTIVE Atypical ( second-generation ) antipsychotics are considered st and ard treatment for children and adolescents with early-onset schizophrenia and schizoaffective disorder . However , the superiority of second-generation antipsychotics over first-generation antipsychotics has not been demonstrated . This study compared the efficacy and safety of two second-generation antipsychotics ( olanzapine and risperidone ) with a first-generation antipsychotic ( molindone ) in the treatment of early-onset schizophrenia and schizoaffective disorder . METHOD This double-blind multisite trial r and omly assigned pediatric patients with early-onset schizophrenia and schizoaffective disorder to treatment with either olanzapine ( 2.5 - 20 mg/day ) , risperidone ( 0.5 - 6 mg/day ) , or molindone ( 10 - 140 mg/day , plus 1 mg/day of benztropine ) for 8 weeks . The primary outcome was response to treatment , defined as a Clinical Global Impression ( CGI ) improvement score of 1 or 2 and > or=20 % reduction in Positive and Negative Syndrome Scale ( PANSS ) total score after 8 weeks of treatment . RESULTS In total , 119 youth were r and omly assigned to treatment . Of these subjects , 116 received at least one dose of treatment and thus were available for analysis . No significant differences were found among treatment groups in response rates  ( molindone : 50 % ; olanzapine : 34 % ; risperidone : 46 % ) or magnitude of symptom reduction . Olanzapine and risperidone were associated with significantly greater weight gain . Olanzapine showed the greatest risk of weight gain and significant increases in fasting cholesterol , low density lipoprotein , insulin , and liver transaminase levels . Molindone led to more self-reports of akathisia . CONCLUSIONS Risperidone and olanzapine did not demonstrate superior efficacy over molindone for treating early-onset schizophrenia and schizoaffective disorder . Adverse effects were frequent but differed among medications . The results question the nearly exclusive use of second-generation antipsychotics to treat early-onset schizophrenia and schizoaffective disorder . The safety findings related to weight gain and metabolic problems raise important public health concerns , given the widespread use of second-generation antipsychotics in youth for nonpsychotic disorders
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 .