Antipsychotics Tied to Insulin Problems in Kids

http://www.healthsentinel.com/news.p...st_item&id=344

Kathleen Doheny, "Antipsychotics Tied to Insulin Problems in Kids",
Forbes, October 21, 2004,
Link: http://www.forbes.com/lifestyle/heal...out521900.html

Prescription drugs commonly used to treat children and teens with
aggression, bipolar disorder and schizophrenia may lead to insulin
problems, in turn boosting the risk of type 2 diabetes and heart
disease later in life, a new study claims.

The research, presented Oct. 20 at the American Academy of Child and
Adolescent Psychiatry meeting in Washington, D.C., echoes what's been
discovered about these drugs when used in adults, said Dr. Mark
Riddle, director of child and adolescent psychiatry at Johns Hopkins
University School of Medicine.

His study, he said, is believed to be the first to find the link
between the antipsychotic drugs and insulin problems in children and
teens.

While the study findings don't mean the drugs should not be
prescribed, Riddle said the message for parents is clear: "Work with
an experienced clinician and focus on the benefit-risk ratio." All
drugs have risks, of course, he said. What's important is to determine
if the benefits from these drugs outweigh the risks for individual
children.

In the study, Riddle and his co-authors evaluated 11 children, aged 10
to 17, who had gained weight while taking three different
antipsychotic drugs -- olanzapine (Zyprexa), quetiapine (Seroquel), or
risperidone (Risperdal).

They found that all six subjects on moderate or high doses of these
drugs, called atypical or "second-generation" antipsychotics, had what
doctors call insulin resistance, in which the body is not using
insulin properly. Three of five on the low doses of the same drugs met
the criteria for insulin resistance. And eight of the nine subjects
found to be insulin-resistant were more insulin-resistant than
predicted based on their weight alone.

While the association between excess weight and insulin resistance has
been well known, Riddle said it's believed the antipsychotic drugs may
have an independent effect on insulin, over and above the effect of
excess weight.

The study results echo what has been found in adults, said Dr. Glen R.
Elliott, an associate professor and director of the Children's Center
at Langley Porter, which is affiliated with the University of
California at San Francisco. "There's been an assumption that this is
likely to be true [in children]," he said, based on research on
adults.

The newer drugs studied, the second-generation drugs, were so named,
Elliott said, because they weren't associated with tardive dyskinesia,
a movement disorder that was a side effect of the first-generation
antipsychotics.

The second-generation drugs work, Riddle said, by binding to receptors
for the neurotransmitter dopamine in the brain, affecting the
transmission of impulses and helping to change behavior and thinking.

Riddle said more study is needed and the results are not in themselves
a reason not to use the drugs. "In certain cases, the use of these
antipsychotics are essential for the child to function," said Dr.
Charles Goodstein, a clinical professor of psychiatry at New York
University Medical School.

Based on anecdotal reports, Goodstein said these agents, like
antidepressants, are sometimes over-prescribed. So parents should ask
the exact diagnosis and ask why the doctor is prescribing the drug.
"These are potent medications, and you don't use them without good
reason," he said. These medications are often used for several years.
And they are valuable for some children, he added.

The best advice for now? Decide whether the benefits outweigh the
risk, Riddle and others agreed.

"Roman Bystrianyk" wrote in message
om...

(...)
The research, presented Oct. 20 at the American Academy of Child and
Adolescent Psychiatry meeting in Washington, D.C.,

(...)

In the study, Riddle and his co-authors evaluated 11 children

This means this is an unpublished study based on only 11 subjects. This is
very preliminary and not peer-reviewed.

It is no more than a hint.

I look forward to a full study of the subject.

Jeff