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

Slide: 34 of 43

Adverse Effects: Second-Generation Antipsychotics Versus Placebo (1 of 2)

The risk and severity of key the adverse events dyslipidemia and weight gain were examined in a meta-analysis of individual second-generation antipsychotics (SGAs) when compared with placebo.

For characteristics of dyslipidemia:

  • Aripiprazole demonstrated a 2.5-fold risk of elevated cholesterol (statistically valid range from 1.4-fold to 4.4-fold). With this increase in risk, when compared with the placebo group, one in every four patients exhibited elevated cholesterol. The strength of evidence for this finding is low.
  • Olanzapine demonstrated a 10-fold risk of elevated cholesterol (statistically valid range from 1.4-fold to 73.2-fold). With this increase in risk, when compared with the placebo group, one in every six patients will exhibit elevated cholesterol. The strength of evidence for this finding is low.
  • Quetiapine treatment elevated triglycerides to 29.1 mg/dL higher than in the placebo group (statistically valid range from 7.3 to 50.9 mg/dL higher). The strength of evidence for this finding is low.
  • The evidence about risperidone effects on blood lipids is insufficient to permit conclusions.
  • There are no available data about ziprasidone effects on blood lipids.

For effects on weight:

  • Aripiprazole treatment resulted in greater weight of the participants, at 0.77 kg more than the placebo group (statistically valid range from 0.4 to 1.2 kg). The strength of evidence for this finding is moderate.
  • Olanzapine treatment resulted in greater weight of the participants, at 4.6 kg more than the placebo group (statistically valid range from 3.07 to 6.13 kg). The strength of evidence for this finding is moderate.
  • Quetiapine treatment resulted in greater weight of the participants, at 1.8 kg more than the placebo group (statistically valid range from1.1 to 2.5 kg). The strength of evidence for this finding is moderate.
  • Risperidone treatment resulted in greater weight of the participants, at 1.8 kg more than the placebo group (statistically valid range from1.1 to 2.1 kg). The strength of evidence for this finding is moderate.
  • Treatment with ziprasidone resulted in no statistically significant difference in weight when compared with placebo. The strength of evidence for this finding is low.