First- and Second-Generation Antipsychotics for Children and Young Adults
Adverse Effects: SGAs Versus SGAs (2 of 2)
For other adverse events in direct comparisons, there is limited evidence of no statistically significant difference between second-generation antipsychotics (SGAs) for effects on insulin levels and glucose control, extrapyramidal symptoms, and sedative effects. The strength of evidence in support of these conclusions is low.
The risk of elevated prolactin is 2.6 times greater with risperidone than with olanzapine (from 1.7x to 5x). The strength of evidence for this conclusion is moderate.
The evidence from other head-to-head comparisons is insufficient to permit conclusions about differences in prolactin levels.
Study durations were typically too short to evaluate adverse effects on some important outcomes such as insulin and glycemic control.
- Seida J, Schouten J, Mousavi S, et al. First- and Second-Generation Antipsychotics for Children and Young Adults. Comparative Effectiveness Review No. 39 (Prepared by the University of Alberta Evidence-based Practice Center under Contract No. 290-2007-10021). Rockville, MD: Agency for Healthcare Research and Quality; February 2012. AHRQ Publication No. 11(12)-EHC077-EF. Available at www.effectivehealthcare.ahrq.gov/pedantipsych.cfm.
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