ArticleJournal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent2010
First do no harm: promoting an evidence-based approach to atypical antipsychotic use in children and adolescents.
Article in Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 71 citations in OpenAlex.
- Harms of Antipsychotics in Children and Young Adults: A Systematic Review Update.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2018Pooled it
- The treatment characteristics of oral antipsychotics in treatment of adolescents with schizophrenia in China.BMC psychiatry · 2025Article
- Development of methods for WHO quality standards for child and youth mental health services to improve quality of care and patient safety in the WHO European region.Frontiers in health services · 2025Article
- Impact of Antipsychotic Guidelines on Laboratory Monitoring in Children with Neurodevelopmental Disorders.Journal of child and adolescent psychopharmacology · 2021Article
- Evidence for clinicians: Atypical antipsychotics for disruptive behaviour disorders in children and youths.Paediatrics & child health · 2019Article
- Article
- Second-generation antipsychotics in children: Risks and monitoring needs.Canadian family physician Medecin de famille canadien · 2018Article
- Prescribing Practices of Quetiapine for Insomnia at a Tertiary Care Inpatient Child and Adolescent Psychiatry Unit: A Continuous Quality Improvement Project.Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent · 2017Article
- A Pilot Study for Understanding the Perceptions of Australian General Practitioners Regarding Psychopharmacology for Children With Autism Spectrum Disorders.Journal of primary care & community health · 2016Article
- System struggles and substitutes: A qualitative study of general practitioner and psychiatrist experiences of prescribing antipsychotics to children and adolescents.Clinical child psychology and psychiatry · 2016Article
- Combined stimulant and antipsychotic treatment in adolescents with attention-deficit/hyperactivity disorder: a cross-sectional observational structural MRI study.European child & adolescent psychiatry · 2015Observational
- Use of quetiapine in children and adolescents.Paediatric drugs · 2015Review
- A Qualitative Study of Antipsychotic Medication Experiences of Youth.Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent · 2015Article
- Atypical antipsychotics for psychosis in adolescents.Paediatrics & child health · 2014Article
- Rising antipsychotic prescriptions for children and youth: cross-sectoral solutions for a multimodal problem.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2014Review
- Therapeutic approaches for shankopathies.Developmental neurobiology · 2014Review
- Some side effects and effcts on physical activity of second-generation antipsychotics: A study in children and adolescents.Advanced biomedical research · 2014Article
- SENTIA: a systematic online monitoring registry for children and adolescents treated with antipsychotics.SpringerPlus · 2014Article
- Trends, correlates, and disease patterns of antipsychotic use among children and adolescents in Taiwan.Social psychiatry and psychiatric epidemiology · 2013Article
- Improving metabolic parameters of antipsychotic child treatment (IMPACT) study: rationale, design, and methods.Child and adolescent psychiatry and mental health · 2013Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo review the evidence for efficacy and metabolic effects of atypical antipsychotics (AAPs), and to propose a metabolic monitoring protocol for AAP use in children and adolescents.
methodsA PubMed search was performed to obtain all studies related to efficacy, metabolic side-effects, and monitoring in those less than 18 years of age.
resultsThere are no approved indications for AAP use in children and adolescents in Canada. Based on US Food and Drug Administration approvals and a review of randomized controlled trials, we identified 7 indications for AAP use that target specific symptoms in youth including schizophrenia, bipolar I disorder, autism, pervasive developmental disorder, disruptive behaviour disorders (including conduct disorder and ADHD), developmental disabilities and Tourette Syndrome. A wide range of metabolic effects including weight gain, increased waist circumference, dysglycemia, dyslipidemia, hypertension, elevated hepatic transaminases and prolactin levels have been reported. We have developed a proposal for metabolic monitoring that includes anthropometric measurements and laboratory testing at baseline and appropriate intervals thereafter.
conclusionThere is an urgent need for national clinical practice guidelines that provide, not only appropriate treatment algorithms for AAP-use based on evidence, but also address metabolic monitoring and subsequent management of complications in this vulnerable population.
Indexed as
Identifiers
20467549PMC2868560W2158828528What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.