Prevention and treatment of obesity and metabolic dysfunction in children with major behavioral disorders: Second-generation antipsychotics

Abstract

Second-generation antipsychotic (SGA) medications are prescribed to children and adolescents for FDA-indicated treatment of irritability in autism, bipolar spectrum disorders, and psychotic symptoms as well as for off-label treatment of severe aggression and mood dysregulation. Unfortunately pediatric patients are particularly vulnerable to metabolic side effects of these medications compared to adults. This chapter reviews pediatric data on SGA-induced weight gain, dyslipidemia, and hyperglycemia/new-onset diabetes. Possible underlying mechanisms of SGA metabolic side effects are discussed, as well as pharmacologic and non-pharmacologic strategies to manage these health issues. Future research is needed to better identify predictors of pediatric metabolic side effects and novel prevention strategies for SGA-induced obesity.