Evidence map›Paper›PMID 27825323›Full record

SynthesisBMC pediatrics2016

Prolactin-related adverse events and change in prolactin levels in pediatric patients given antipsychotics for schizophrenia and schizophrenia spectrum disorders: A systematic review.

Eric Druyts, Michael J Zoratti, Kabirraaj Toor, Ping Wu, Salmaan Kanji, Kiran Rabheru, Edward J Mills, Kristian Thorlund

Open access · goldAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC pediatrics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 23% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 11 citations in OpenAlex.

  1. Review
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Eric DruytsFaculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada. edruyts@gmail.com.
Michael J ZorattiDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Kabirraaj ToorFaculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
Ping WuFaculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
Salmaan KanjiDepartment of Pharmacy of the Ottawa Hospital, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Kiran RabheruDepartment of Psychiatry, Ottawa Hospital, Ottawa, ON, Canada.
Edward J MillsFaculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
Kristian ThorlundDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
University of Ottawa · CAMcMaster University · CAOttawa Hospital · CA

Funding

CIHR
6 · The paper itself

Abstract

backgroundSecond-generation antipsychotics are commonly prescribed for pediatric patients with schizophrenia and schizophrenia spectrum disorders despite their lack of approval for use in children. Although considered a safer alternative to first-generation antipsychotics, there is evidence to suggest that second-generation antipsychotics may be associated with some adverse events as well as an increase in prolactin levels. The purpose of this review is to examine the risk of prolactin-related adverse events in pediatric patients using antipsychotics and to quantify changes in prolactin for this population.

methodsLiterature searches were conducted in Medline, Embase, the Cochrane Central Register of Controlled Trials, and PsycINFO databases, supplemented with review of select gray literature to identify both randomized controlled trials and observational studies on pediatric patients prescribed antipsychotic medications for schizophrenia or schizophrenia spectrum disorders. Using a narrative approach, data on adverse events were recorded and changes from baseline in prolactin were pooled, where possible, from the randomized trials. Change from baseline in prolactin was evaluated for each treatment, as well as in comparison to placebo and to other treatments. Where data was available, these changes were evaluated separately for male and female patients.

resultsSix randomized controlled trials and five observational studies, all examining the effects of second-generation antipsychotics, were selected. Literature reporting the effects of risperidone, quetiapine, aripiprazole, olanzapine, and paliperidone was identified, with varying doses. Prolactin-related adverse events were sparsely reported across studies. In evidence gathered from randomized controlled trials, risperidone, olanzapine, and two doses of paliperidone (3-5 mg/day and 6-12 mg/day) were associated with increased prolactin levels compared to baseline. With the exception of paliperidone, similar trends were observed in males and females, separately. The findings of the observational evidence served to both complement and run contrary to the randomized trials, with discrepancies attributed to differences in patient and treatment characteristics.

conclusionsNo definitive conclusions between second-generation antipsychotic use and prolactin-related adverse events can be made based on the available literature. While some trends in prolactin level changes emerged, this was based on few trials with small sample sizes. Future investigations should emphasize reporting on treatment safety.

trial registrationPROSPERO CRD42014009506 .

Indexed as

Antipsychotic AgentsBiomarkersChildHumansHyperprolactinemiaProlactinSchizophreniaAntipsychotic AgentsBiomarkersProlactinPediatricProlactinSchizophreniaSystematic review

Identifiers

PMID27825323
PMCPMC5101725
OpenAlexW2554776302

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.