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Antipsychotic Use in Children and Adolescents: Minimizing Adverse Effects to Maximize Outcomes

In children and adolescents, antipsychotics are being used in large and increasing quantities for a wide range of disorders and psychopathology, including psychotic, mood, and disruptive behavior disorders (1). Moreover, antipsychotics are also being used in children and adolescents to treat irritability associated with autism, tic disorders, obsessive-compulsive disorder, posttraumatic stress disorder and aggression; (2–4) however, the widespread use exceeds the database regarding efficacy as well as safety and tolerability in this population. At the time of this writing, only three antipsychotics—haloperidol, thioridazine, and risperidone—have been approved for use in children and adolescents by the U.S. Food and Drug Administration, with most randomized controlled data being available for risperidone. To appropriately use this potent class of medications, clinicians need to actively weigh the potential risks and benefits of individual agents. The present article aims to succinctly review available data on antipsychotic-related adverse effects in children and adolescents and provide a practical guide for the evaluation and management of antipsychotic-related adverse effects in this vulnerable population.

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