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Second generation antipsychotics (SGAs) are commonly associated with metabolic complications. These medications are being used more frequently for the treatment of mental health disorders in children, which has stimulated the need for creating formal guidelines on monitoring their safety and effectiveness. Previous guidelines have been developed for monitoring for metabolic and neurological complications. In order to assist practitioners who perform these monitoring procedures, we have created a complementary set of treatment recommendations if abnormal measurements or results are encountered. To create evidence-based recommendations to assist in managing metabolic complications in children being treated with second generation antipsychotics. A systematic review of the literature on metabolic complications of second generation antipsychotic medications in children was conducted. Members of the consensus group evaluated the information gathered from the systematic review of the literature and used a nominal group process to come to consensus on treatment recommendations. Wherever possible, references were made to existing guidelines on the evaluation and treatment of metabolic abnormalities in children. Evidence-based recommendations are presented to assist in managing metabolic complications, including weight gain, increased waist circumference, elevation in cholesterol, triglycerides and glucose, liver function tests, abnormal thyroid studies, and elevation in prolactin. The use of SGAs requires proper monitoring procedures. This treatment guideline provides guidance to clinicians on clinical management of metabolic complications if they occur.


Josephine Ho, Constadina Panagiotopoulos, Brian McCrindle, Silviu Grisaru, Tamara Pringsheim, CAMESA guideline group. Management recommendations for metabolic complications associated with second generation antipsychotic use in children and youth. Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Académie canadienne de psychiatrie de l'enfant et de l'adolescent. 2011 Aug;20(3):234-41

PMID: 21804854

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