Secondary effects of antipsychotic treatment in naive or quasi-naive children and adolescents: design of a follow-up protocol and baseline results.

Introduction: The prescribing of anti-psychotic drugs has become a normal clinical practice.

Methods: This article presents a longitudinal, multicentre study of 12 months conducted on 266 children and adolescents who were prescribed a first or second generation antipsychotic drug for the first time, and the baseline results of the study. The follow-up protocol had as its purpose to detect the possible appearance of metabolic, cardiological, and motor changes.

Results: When the presence of side effects was evaluated using the UKU (clinical side-effects scale) statistically significant differences were found between naive (patients who had never taken an anti-psychotic drug) and quasi-naive patients (those who have taken anti-psychotic drugs for a period of less than 30 days), with a greater number of the latter showing symptoms of: anxiety/laxity/tiredness (P=.0049), drowsiness/sedation (P<.001), increase in dream duration (P<.001), increase in dreams (P=.0199), emotional indifference (P=.0194), hypokinesia/akinesia (P=.0224), paresthesias (P=.0049), accommodation disorder (P=.0254), increase in salivation (P<.001), polyuria/polydipsia (P=.0076), increase in sweating (P=.0076), increase in sexual desire (P=.0117), decrease in sexual desire (P=.0053), tension headaches (P=.0405). When the presence of extrapyramidal symptoms was assessed using the MPRC-IMS (Maryland Psychiatry Research Center-Involuntary Movements) Scale, it was observed that the quasi-naïve patients had a statistically higher number of dyskinesia (P=.002), Parkinsonism (P=.0004) and akathisia (P=.0437) symptoms compared to the naïve patients.

Conclusions: These results show that, in the childhood-adolescent population, the presence of secondary effects begins to be observed from the first dose of the antipsychotic drug.