O12.1. CARDIOMETABOLIC ADVERSE EFFECTS AND ITS PREDICTORS IN CHILDREN AND ADOLESCENTS WITH FIRST-EPISODE PSYCHOSIS DURING TREATMENT WITH QUETIAPINE-ER VERSUS ARIPIPRAZOLE: 12-WEEK RESULTS: FROM THE TEA TRIAL

Abstract

Background: Children and adolescents are more prone to develop adverse effects during antipsychotic treatment than adults. The purpose of this paper iso investigate cardiometabolic effects and its predictors in youth with first-episode psychosis (FEP) treated with quetiapine-extended release (ER) vs. aripiprazole. Method(s): Youths with FEP aged 12-17 years were randomized to quetiapine- ER or aripiprazole in the 12-week, double-blinded, Tolerability and Efficacy of Antipsychotics (TEA) trial. Primary outcome was change in body weight; secondary outcomes were changes in body mass index (BMI) and waist circumference (WC), blood pressure (BP), heart rate, and lipid and glucose metabolism parameters. Possible predictors of cardiometabolic changes were examined. Result(s): Altogether, 113 patients (schizophrenia-spectrum disorders= 93%, age (mean+/-SD): 15.7+/-1.4 years, males=30.1%), were randomized to quetiapine-ER (n=55) or aripiprazole (n=58). Quetiapine-ER was associated with significantly larger increases in body weight, BMI z-score and WC z-score than aripiprazole (all between-group p-values p<0.0001): Lipid and glucose metabolism parameters increased significantly at week 4 and 12 only with quetiapine-ER (p-range: 0.0001-0.037). Quetiapine-ER was associated with an increased occurrence of obesity, elevated blood lipids and hyperinsulinemia (p-range=0.004-0.039). Early weight gain, obesity or type 2 diabetes in the family significantly predicted weight and BMI gain at week 12. Discussion(s): In youth with FEP, quetiapine-ER was associated with significantly greater weight gain and adverse changes in metabolic outcomes than aripiprazole. Early weight gain must be addressed and family lifestyle factors taken into consideration when treating youth with antipsychotics.