Second generation antipsychotics in 'real-life' paediatric patients. Adverse drug reactions and clinical outcomes of drug switch

Expert Opin Drug Saf. 2016 Dec;15(sup2):1-8. doi: 10.1080/14740338.2016.1229301.

Abstract

Objective: Gap in knowledge on benefit/risk ratio of second generation antipsychotics (SGA) in the paediatric population represents a challenge for the scientific community. This study aims to analyse all suspected adverse drug reactions (ADRs) to SGA observed during the study period; compare the safety profiles of risperidone and aripiprazole; evaluate the effect of switching from risperidone to aripiprazole or to a first generation antipsychotic (FGA).

Methods: Prospective analysis of spontaneously reported ADRs concerning 184 paediatric outpatients between 2012 and 2014.; clinical outcomes of drug switch were evaluated.

Results: Out of the 184 patients, 130 experienced at least one ADR; ADRs were usually not serious and more frequently associated with aripiprazole. Switching to aripiprazole was associated with better results than switching to FGAs in the Clinical Global Impression scale- Efficacy (CGI-E) scores (p = 0.018), Disturbed behaviour checklist-parents (DBC-P) self-absorption subscale (p = 0.010); only a trend for difference between changing to aripiprazole vs FGAs in the DBC-P total score (p = 0.054) and social relating subscale (p = 0.053) was observed.

Conclusions: SGAs safety data were consistent with the ones already known; however, there is still a need to improve the knowledge in pharmacovigilance field among clinicians. Switching to aripiprazole may be a valid alternative to risperidone.

Keywords: Adverse drug reactions; aripiprazole; pharmacovigilance; risperidone; second-generation antipsychotics.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adolescent
  • Antipsychotic Agents / administration & dosage
  • Antipsychotic Agents / adverse effects*
  • Aripiprazole / administration & dosage
  • Aripiprazole / adverse effects*
  • Child
  • Drug Substitution
  • Female
  • Humans
  • Male
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Risperidone / administration & dosage
  • Risperidone / adverse effects*

Substances

  • Antipsychotic Agents
  • Aripiprazole
  • Risperidone