Vektøktning og metabolsk effekt av stemningsstabiliserende legemidler og antipsykotika ved pediatrisk bipolar lidelse: systematisk oversikt og samlede resultater fra studier av kort varighet

Weight gain and metabolic effects of mood stabilizers and antipsychotics in pediatric bipolar disorder: A systematic review and pooled analysis of short-term trials

Forfattere
Correll, C. U.
Årstall
2007
Tidsskrift
Journal of the American Academy of Child and Adolescent Psychiatry
Volum
46
Sider
687-700
Objective: To review weight and metabolic effects of mood-stabilizing treatments in pediatric bipolar disorder. Method: Systematic PubMed/fidedfine search of studies reporting on change in weight and/or glucose/lipid values with mood-stabilizing drugs in at least nine pediatric patients with bipolar disorder. Results: Nineteen studies, including 24 medication trials in 684 patients (mean age, 12.3 +/- 2.9 years) were included. Youngsters received lithium, antiepileptics, or their combinations (n = 459), or second-generation antipsychotics, alone or combined with lithium or divalproex (n = 225), for 4 to 48 (mean, 15.4 +/- 12.7) weeks. Weight increase was significant/clinically relevant in 18 (75.0%) trials. Weight loss was significant with topiramate (2 studies, 38 subjects) and present with aripiprazole (1 study, 14 subjects). In trials lasting <= 12 weeks, weight gain was greater with second-generation antipsychotics plus mood stabilizers (5.5 +/- 1.8 kg) compared to mood-stabilizer monotherapy (1.2 +/- 1.9 kg, p < .05, Cohen's d = 2.33) or mood-stabilizer cotreatment (2.1 +/- 1.3 kg, p < .05, Cohen's d = 2.17), but not compared to antipsychotic monotherapy (3.4 +/- 1.3 kg, p > .05, Cohen's d = 1.34). Nonfasting glucose/lipid changes were nonsignificant in two second-generation antipsychotic trials (n = 61, 8.9%). Conclusions: Data are sparse regarding body composition effects and lacking for fasting metabolic effects of mood stabilizers in pediatric bipolar disorder. Combining antipsychotics with mood stabilizers seems to lead to greater weight gain than treatment with one or two mood stabilizers.

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Tiltaksnivå

Behandling og hjelpetiltak

Tema

Psykiske vansker og lidelser

Følelsesmessige problemer

Bipolare lidelser

Tiltak

Medikamentell behandling

Antidepressiva

Antipsykotisk medisin

20.60 Epilepsimedisin

Aldersgruppe

Barn i skolealder (6-12 år)

Ungdom (13-18 år)

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