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Multiple antipsychotic use associated with metabolic and cardiovascular adverse events in children and adolescents

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QUESTION

Question:

What factors are associated with metabolic and cardiovascular adverse events in antipsychotic treated children and adolescents?

People:

4140 children and adolescents (aged ⩽17 years, mean age 10.4 years; 68% male; 42% white and 41% African American; enrolled in Medicaid for a minimum of 9 months each year) prescribed one of five atypical antipsychotics or two conventional antipsychotics, and a random sample of 4500 children and adolescents not prescribed any psychotropic medication, including antipsychotics, between 1 January 1998 and 31 December 2003.

Setting:

Medicaid programme, South Carolina, USA; January 1996 to December 2005.

Risk factors:

Use of atypical or conventional antipsychotic use, multiple antipsychotics, mood stabilisers or selective serotonin reuptake inhibitors (SSRIs) based on pharmacy claim data. Analyses were adjusted for confounders, including age, sex, ethnicity and pre-existing conditions.

Outcomes:

Prevalence and incidence of metabolic conditions (obesity, type 2 diabetes mellitus, dyslipidaemia), hypertension, cardiovascular events, cerebrovascular events and orthostatic hypotension. Outcomes were identified by looking for the relevant ICD-9 CM codes in medical claims data. Cases developing after the first prescription date were considered incident cases, and outcomes in the 24 months preceding the …

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