First- and Second-Generation Antipsychotics for Children and Young Adults. Executive Summary. Effective Health Care Program. Comparative Effectiveness Review Number 39.

摘要

Antipsychotic medications are widely used to treat several psychiatric disorders and are commonly categorized into two classes. First-generation antipsychotics (FGAs), also known as typical antipsychotics, were developed in the 1950s. Although they are used to treat psychotic symptoms, they are associated with various side effects including extrapyramidal symptoms, which are movement disorders characterized by repetitive, involuntary muscle movements, restlessness, or an inability to initiate movement. Other common side effects are dry mouth and sedation. Neuroleptic malignant syndrome and tardive dyskinesia are rare but serious side effects. Second-generation antipsychotics (SGAs), also known as atypical antipsychotics, emerged in the 1980s. They are generally thought to have a lower risk of motor side effects. However, SGAs are associated with a higher risk of weight gain, elevated lipid and prolactin levels, and development of type 2 diabetes. Use of antipsychotics for children and adolescents has increased during the past 20 years. Prescribing antipsychotics to the pediatric population is controversial because there are few high-quality and longitudinal studies on which to base clinical practice recommendations.