Atypical antipsychotics in children with pervasive developmental disorders

Area of Science:

• Child and Adolescent Psychiatry
• Neurodevelopmental Disorders
• Pharmacology

Background:

• Pervasive developmental disorders (PDDs) present significant treatment challenges, requiring integrated behavioral and pharmacological approaches.
• Limited data historically existed on medication use in children with PDDs, but recent research has increased.
• Atypical antipsychotics (AAs) are a focus of current research for PDD symptom management.

Purpose of the Study:

• To review existing literature on the efficacy and safety of atypical antipsychotics (AAs) in children diagnosed with pervasive developmental disorders (PDDs).
• To evaluate specific AAs, highlighting those with substantial evidence and potential as treatment options.

Main Methods:

• Systematic review of published literature, including double-blinded, placebo-controlled trials and open-label studies.
• Focus on research investigating atypical antipsychotics (AAs) for behavioral symptoms in children with PDDs.

Main Results:

• Risperidone demonstrates consistent efficacy in improving aggression, irritability, self-injurious behavior, and mood instability in children with PDDs, supported by extensive clinical trials.
• Ziprasidone and aripiprazole show promise as alternative AA treatments, though data is less extensive.
• Olanzapine and quetiapine exhibit limited clinical benefit and carry risks of significant weight gain and sedation; all AAs pose a risk of metabolic syndrome requiring monitoring.

Conclusions:

• Atypical antipsychotics (AAs) can be effective in alleviating challenging behavioral symptoms associated with PDDs in children.
• Risperidone is a well-supported option, while ziprasidone and aripiprazole warrant further investigation.
• AAs should be considered a valuable component of a comprehensive treatment strategy for children with PDDs, with careful patient monitoring for side effects.