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Review: Children and adolescents with schizophrenia spectrum disorders respond to antipsychotics, but are susceptible to adverse events

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Sanjiv Kumra

Correspondence to: Sanjiv Kumra, Division of Child and Adolescent Psychiatry, University of Minnesota Medical School, 2450 Riverside Avenue, F256/2B, Minneapolis, MN 55454, USA; kumra002@umn.edu

QUESTION

Question:

How effective and safe are antipsychotics for children and adolescents with early onset schizophrenia spectrum disorders?

Outcomes:

Any efficacy outcome (symptoms, response, time to discontinuation), adverse events.

METHODS

Design:

Systematic review.

Data sources:

MEDLINE (searched 1970–2007), hand search of reference lists and conference abstracts, as well as contact with investigators in the field and drug manufacturers.

Study selection and analysis:

Double-blind randomised controlled trials (RCTs) of antipsychotics for early onset schizophrenia spectrum disorders were included. Trials had to include 15 or more participants (children and adolescents) and last for at least 4 weeks.

MAIN RESULTS

Ten RCTs, three of first generation antipsychotics (FGAs) and seven of second generation antipsychotics (SGAs), met inclusion criteria. Average age of participants ranged from about 9–16 years. Most of the trials were small and of short duration. First generation antipsychotics: two RCTs (n = 91) compared haloperidol versus placebo for four or six weeks, one of which also had a loxapine group. A third RCT (n = 21) compared thiothixene …

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