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First- and Second-Generation Antipsychotics for Children and Young Adults

Slide: 33 of 43

Summary of Adverse Effects of First-Generation Antipsychotics

For comparisons between first-generation antipsychotics (FGAs) or with placebo, the evidence is insufficient to permit conclusions about the degree of risk or severity of adverse effects in pediatric use.

In direct comparisons of the FGA haloperidol with second-generation antipsychotics (SGAs) in pediatric use:

When compared with olanzapine:

  • Haloperidol shows lower risk for adverse effects on weight and body composition but greater risk of extrapyramidal symptoms.
  • No statistically significant differences are noted for prolactin-related effects or sedation.

The strength of evidence in support of these conclusions is low.

When compared with risperidone:

  •  The risk of extrapyramidal symptoms and sedative effects is greater with haloperidol.
  •  No statistically significant differences in risk are noted for adverse effects on weight and body composition or prolactin-related effects.

The strength of evidence in support of these conclusions is low.