The safety of olanzapine in young children: a systematic review and meta-analysis

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Jacqueline Flank1, Lillian Sung, Christopher C Dvorak

  • 1Department of Pharmaceutical Sciences and Department of Pharmacy, Leslie Dan Faculty of Pharmacy, University of Toronto and The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada, jacqueline.flank@sickkids.ca.

Drug Safety
|August 23, 2014
PubMed

Insights

Olanzapine use in children under 13 for chemotherapy-induced nausea and vomiting (CINV) shows mostly minor side effects like weight gain and sedation. These findings support further trials for CINV prevention in pediatric patients.

Area of Science:

  • Pediatric pharmacology
  • Oncology supportive care
  • Clinical toxicology

Background:

  • Olanzapine is commonly prescribed for psychiatric conditions in children.
  • Its potential use for chemotherapy-induced nausea and vomiting (CINV) in pediatric patients warrants safety evaluation.
  • This review assesses olanzapine's safety profile in children under 13 for CINV prevention.

Purpose of the Study:

  • To review the safety of olanzapine in children younger than 13 years.
  • To determine if safety concerns preclude its use for CINV prevention in this age group.

Main Methods:

  • Comprehensive electronic searches across major biomedical databases (MEDLINE, EMBASE, Cochrane, Web of Science, Scopus).
  • Inclusion of all English-language studies reporting adverse effects of olanzapine in children under 13.
  • Synthesis of adverse outcomes from prospective studies.

Main Results:

  • 47 studies (17 prospective) involving 387 children were analyzed.
  • Common adverse events included weight gain (78%) and sedation (48%).
  • Other reported events: extrapyramidal symptoms (9%), ECG abnormalities (14%), elevated liver function tests (7%), and blood glucose abnormalities (4%). No deaths were reported.

Conclusions:

  • Most olanzapine-associated adverse events in children under 13 are of minor clinical significance.
  • The safety profile appears acceptable for exploring olanzapine in CINV prevention trials.
  • Further research is needed to confirm efficacy and safety in pediatric CINV management.
Abstract

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