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 .
Plasma clozapine and haloperidol concentrations in adolescents with childhood-onset schizophrenia: association with response.
BACKGROUND Plasma clozapine and haloperidol concentrations were studied in adolescents being treated for childhood-onset schizophrenia . METHOD Eleven patients ( 9 boys , 2 girls ; mean age = 14.1 + /- 2.1 years ) received a 6-week blinded or open trial of clozapine . Five patients also received 6 weeks of blinded or open haloperidol . Doses were increased on an individual basis to a mean 6-week dose of 5.99 + /- 2.6 mg/kg/day for clozapine and 0.24 + /- 0.20 mg/kg/day for haloperidol . The Brief Psychiatric Rating Scale and Bunney Hamburg Rating Scale were completed weekly for each subject . Weekly blood sample s were obtained during therapy and assayed by high performance liquid chromatography . RESULTS The mean  clozapine level at Week 6 was 378.3 ng/mL and ranged from 77.5 to 1050 ng/mL. The mean Week 6  haloperidol level was 23.0 ng/mL ( range , 6.2 - 44.3 ng/mL ) . The clozapine desmethyl and N-oxide metabolites achieved mean concentrations of 77 % and 18 % , respectively , of those of the parent compound . The mean ratio of haloperidol/reduced haloperidol  was 4.48 ( range , 0.76 - 8.76 ) .  Clozapine concentrations versus clinical benefit exhibited a consistent linear relationship among patients ( correlation range , 0.26 - 0.96 ) . Conversely , poor and inconsistent correlations between  haloperidol concentrations and clinical effects were observed . No relationships were noted between  clozapine or haloperidol dose and clinical effects . CONCLUSION Adolescents with schizophrenia produce a greater amount of desmethylclozapine than previously seen in adults . Plasma clozapine concentrations appear to be related in a linear fashion to clinical improvement
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 .