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P-287 - Atypical Antipsychotics for Psychosis in Adolescents

Published online by Cambridge University Press:  15 April 2020

V. Furtado
Affiliation:
University of Nottingham, Nottingham, London, UK
A. Kumar
Affiliation:
Leeds Partnerships NHS Foundation Trust, Leeds, London, UK
S. Datta
Affiliation:
King's College, London, UK
S. Wright
Affiliation:
Leeds Partnerships NHS Foundation Trust, Leeds, London, UK
P. Russell
Affiliation:
Christian Medical College and Hospital, Vellore, India

Abstract

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Introduction:

Schizophrenia often presents in adolescence (13–18 years), is more likely to have a poor prognosis and young people are also more prone to adverse effects. Clearer guidance is needed in order to plan treatment for early onset cases more effectively.

Objectives:

We aimed to evaluate effects of atypical antipsychotic medications for psychosis in adolescents.

Search methods:

We searched the Cochrane Schizophrenia Group's Register. References of all identified studies were inspected for further trials.

Methodology:

All relevant RCTs that compared atypical antipsychotic medication with pharmacological or non-pharmacological interventions in adolescents with psychosis were included. We reliably selected, quality assessed and extracted data from trials.

Results:

There were 13 RCTs with a total of 1112 participants. Adolescents improved more on standard dose of risperidone (1.5 – 6.0 mg) against low dose of risperidone (0.15 – 0.6 mg) (1 RCT, n = 255, RR 0.54 CI 0.38 to 0.75). Participants on clozapine were three times more likely to have drowsiness as compared to haloperidol (1 RCT, n = 21, RR 3.30 CI 1.23 to 8.85, NNH 2 CI 2 to 17). Lesser number of adolescents on atypical antipsychotics left the study due to adverse effects (3 RCTs, n = 187, RR 0.65 CI 0.36 to 1.15) than on typical antipsychotics.

Authors' conclusions:

There is no convincing evidence that atypical-antipsychotic medications are superior over typical antipsychotic medications. There is some evidence to show that adolescents respond better to standard-dose as opposed to lower dose of medications. Larger, more robust, trials are required.

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Abstract
Copyright
Copyright © European Psychiatric Association 2012
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