Antipsychotic drugs may affect children's adiposity and insulin sensitivity

Aripiprazole, olanzapine, and risperidone appear to increase body fat and change insulin sensitivity in children being treated for disruptive behavior disorders, according to new research presented at the meeting of the American Diabetes Association in San Diego.

Researchers funded by the National Institute of Mental Health conducted the Metabolic Effects of Antipsychotics in Children (MEAC) study that analyzed the effects of 12 weeks of randomized treatment with aripiprazole, olanzapine, or risperidone on measures of adiposity and insulin sensitivity in 125 children aged 6 to 18 years with disruptive behavior disorders who were not previously treated with antipsychotics.

Assessments at baseline and again at 12 weeks included body composition analysis with dual energy x-ray absorptiometry and abdominal magnetic resonance imaging, hyperinsulinemic-euglycemic clamps with stable isotopomer tracing, and fasting plasma analyses.

Antipsychotic treatment caused adverse changes in all 3 groups. Body fat increased (PP=.055). Significantly, treatment also resulted in a mean decrease in Aberrant Behavior Checklist irritability/aggression subscale scores by a mean 16.64 points (P=0.520).

Such metabolic effects are associated with increased cardiovascular and diabetes risk, say researchers, and emphasize the importance of balancing potential risks and benefits during use of antipsychotics in pediatric populations.

Newcomer JW, Nicol GE, Yingling MD, Flavin KS, Schweiger JA, Hessler MA. Metabolic effects of antipsychotics in children (MEAC): primary endpoint results. Presented at: 71st Scientific Sessions, American Diabetes Association; June 24-28, 2011; San Diego, CA. Abstract No. 0128-OR.