Male-Specific Metabolic Considerations Concerning the Prescription of Second-Generation Antipsychotics to Adolescents

Although males and females gain comparable weight when prescribed second-generation antipsychotics (SGAs), males may be uniquely vulnerable to an array of endocrinological, inflammatory, and psychosocial adverse drug effects. This opinion piece reviews work in each of these three areas for consideration. Androgens may decrease both through hypothalamic-pituitary-gonadal axis dysregulation and as a consequence of increased adiposity. Testosterone has anti-inflammatory properties, and declining levels as well as many other factors may influence overall immunological functioning. Psychosocial stressors are gender specific in obesity, and SGA-induced obesity may affect males in unique and severe ways. This opinion piece supports the framework of the World Federation of Societies of Biological Psychiatry's Task Force on Men's Mental Health to advocate for further studies concerning the adverse drug effects of SGAs as unique manifested in male children, adolescents, and young men.