Çocuk ve Ergenlerde Atipik Antipsikotik İlaçların Metabolik ve Endokrin Yan Etkileri

Çocuklarda eş tanılı psikiyatrik bozukluklar, sık hastaneye yatış, ayaktan tedavi başvurularının fazlalığı ve hipertansiyon, obezite ve lipid bozuklukları öyküsü yüksek metabolik sendrom riski ile ilişkilendirilmiştir. Çocuk ve ergenlerde antipsikotik ilaç kullanımının artması nedeniyle ilaç yan etkileri ve bu yan etkilerin yönetimi de önem kazanmaktadır. Literatürde genel olarak antipsikotiklerle ilişkili metabolik sendromda önleyici yaklaşımların ikincil ve üçüncül yaklaşımlara göre daha çok tercih edildiği vurgulanmıştır. Klinisyenlerin çocuk ve ergen hasta grubunda antipsikotik ilaç kullanımına bağlı endokrin ve metabolik yan etkilere multidisipliner yaklaşım sergilemeleri ve çoklu ilaç kullanımından kaçınmaları önerilmektedir. Bu yazıda çocuk ve ergen hasta grubunda ikinci kuşak antipsikotik ilaçların metabolik yan etkileri, metabolik sendroma yatkınlığın olası nedenleri ve kilo artışını önlemeye yönelik farmakolojik ve farmakolojik olmayan tedavi yaklaşımları kısaca gözden geçirilmiştir.

Metabolic and Endocrine Side Effects of Atypical Antipsychotic Drugs in Children and Adolescents

Comorbid psychiatric disorders, frequent hospitalization, multiple outpatient treatment, prior history of hypertension, obesity and lipid dysregulation are associated with higher risk of metabolic syndrome in children. Side effects of antipsychotic drugs and their management have recently become a major subject of research due to enhanced antipsychotic drug usage in child and adolescents. Prevention strategies are usually preferred to secondary or tertiary strategies in the management of metabolic syndrome associated with antipsychotic drugs. Clinicians should present multidisciplinary approach to endocrine and metabolic side effects due to antipsychotic use in pediatric patient groups and avoid multiple drug use in such patients. In this paper, we briefly reviewed metabolic side effects of second generation antipsychotic drugs in child and adolescent population, possible mechanisms of susceptibility to metabolic syndrome and pharmacological and non pharmacological treatment approach to prevention of weight gain.

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