Study Examines Antipsychotic Treatments for Children and Teens With Schizophrenia
> 2/29/2008 1:48:45 PM

Treatment of adolescents with schizophrenia can be challenging, especially if symptoms do not improve from treatment with the antipsychotic medications typically used in initial treatment of the disorder. Few studies have investigated the effectiveness of different antipsychotic medications for this age range. In a new study, which appears in the March issue of Biological Psychiatry, researchers compared the effectiveness of two atypical antipsychotics, clozapine (Clozaril) and olanzapine (Zyprexa), in children and teens with treatment-resistant schizophrenia.

The study included 39 patients, aged 10 through 18, who had not seen an improvement in symptoms following treatment with at least two antipsychotics. They were randomly assigned to receive treatment with either clozapine or olanzapine. After 12 weeks of treatment, clozapine was associated with greater levels of improvement in both positive (abnormal thoughts or perceptions, such as delusions and hallucinations) and negative (an absence of or decrease in emotions or social behavior) symptoms of schizophrenia. While 66% of those taking clozapine experienced these benefits, only 33% of those taking olanzapine had the same results.

These medications can greatly benefit patients suffering from the debilitating symptoms of schizophrenia, but they do not come without adverse side effects, and its important to take their risks as well as their benefits into consideration, especially when a patient is young. Most antipsychotics can cause significant weight gain and put patients at risk for obesity-related health conditions, like hypertension and diabetes. Previous studies have addressed this issue and identified ways for patients taking antipsychotics to counter unhealthy weight gain. Although this study indicates that clozapine may be effective for children and teens, it does not take into account the severe side effects associated with that drug in particular. Clozapine can cause myocarditis (swelling of the heart) and agranulocytosis (a decrease in white blood cells) among other things. The drug is offten considered a last resort, and patients taking clozapine must be monitored closely to prevent these problems from developing. Some recent studies are leading the way toward new forms of medication for schizophrenia, and these new antipsychotics may carry a decreased risk of side effects.

For most people with schizophrenia, antipsychotics along with therapy will offer relief from symptoms and allow them to better manage their condition. For those who do not find this relief from the most effective and well-tolerated medications, subsequent treatment with a different antipsychotic can be life-saving. Most of this study's participants had a history of hospitalizations, violence, and suicidal behaviors, and successful treatment is necessary to improve their well-being and their lives. This study represents one of the first steps to creating evidence based practices for some of the youngest sufferers of schizophrenia. Further study of antipsychotic treatment in young patients will give physicians the information they need to fully address both the risks and the benefits of medications prescribed to these patients.

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