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Efficacy of antipsychotics for irritability and aggression in children: a meta-analysis

Gerrit I van Schalkwyk1, Alan S Lewis2, Chad Beyer1

  • 1a Child Study Center , Yale University , New Haven , CT , USA.

Expert Review of Neurotherapeutics
|August 30, 2017
PubMed

Insights

Antipsychotics effectively reduce aggression and irritability in children. Risperidone and aripiprazole showed significant benefits, with efficacy not varying by diagnosis or medication type.

Area of Science:

  • Child and Adolescent Psychiatry
  • Pharmacology
  • Evidence-Based Medicine

Background:

  • Aggression and irritability in children are prevalent issues with significant psychosocial and economic impacts.
  • Antipsychotic medications are commonly used to manage these symptoms in pediatric populations.

Purpose of the Study:

  • To evaluate the overall efficacy of antipsychotics in treating aggression and irritability in children.
  • To compare the effectiveness of different antipsychotic agents, diagnostic indications, and dosages.

Main Methods:

  • A random effects meta-analysis of 14 randomized controlled trials was performed.
  • Effect sizes for antipsychotics were extracted and analyzed.
  • Subgroup analyses and meta-regression were conducted to explore variations in efficacy.

Main Results:

  • Antipsychotics demonstrated significant efficacy in reducing aggression and irritability (SMD = 0.74).
  • Risperidone and aripiprazole showed a significant benefit over placebo.
  • Efficacy did not differ based on diagnostic indication, specific medication, or antipsychotic dose.

Conclusions:

  • Clinical evidence supports risperidone and aripiprazole for managing childhood aggression and irritability across various diagnoses.
  • Current data suggests no significant difference in efficacy among antipsychotic agents or based on the underlying diagnosis.
Abstract

Keywords:
Adolescentsaggressionantipsychoticschildrenirritability

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