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Review of the long-term effect of the atypical antipsychotic medication on the bone mineral density of the pediatric patient with consideration of autism spectrum disorder

By: Al Jumaili, Wisam.
Contributor(s): Muzwagi, Ashraf.
Publisher: New Delhi SAGE 2022Edition: Vol.13(1), Mar.Description: 24-30p.Subject(s): PHARMACOLOGYOnline resources: Click here In: Journal of pharmacology and pharmacotherapeuticsSummary: Objectives: To shed some light on the understudied complication of chronic prolonged exposure to antipsychotics (AP) in children with consideration to with autism spectrum disorder (ASD). Methods: We electronically searched PubMed, Google Scholar, clinical trial.gov, and Medline Database of clinical studies up to June 2021. We used the following keywords: “bone mineral density, osteoporosis, osteopenia, bone loss, bone changes” AND “antipsychotics, SGAs, atypical antipsychotics” AND “pediatric, adolescent, young, youth, children.” We used [Mesh] Term for “antipsychotics agent” and “bone mineral density” and “autism spectrum disorder” and “child.” We retrieved relevant observational studies, reviews, case series, and randomized clinical trials. Results: Yvette Roke et al., in 2012, reported in a retrospective observational study that lumbar spine bone mineral density (BMD) and the biochemical bone marker were lower in the AP-treated boy with hyperprolactinemia in comparison to the non-AP-treated group, while a retrospective observational study of institutional adolescents with a psychiatric condition, carried out by Bonnot et al. in 2011, found significant vitamin D deficiency in psychiatric inpatient adolescents that is unrelated to the specific APs. Third, Calarge et al. in a 2010 retrospective observational study have reported a significant reduction in BMD in adolescents with risperidone-induced hyperprolactinemia and selective serotonin reuptake inhibitor (SSRI) compared to another group with risperidone-induced hyperprolactinemia without SSRI. On the other hand, Nivin A. Nagiub et al. (2019) in the cross-sectional study found no correlation between BMD and AP use in children with ASD. Houghton et al., in 2021, found a high fracture prevalence of 38% with aripiprazole compared to risperidone in children with ASD.
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Objectives:
To shed some light on the understudied complication of chronic prolonged exposure to antipsychotics (AP) in children with consideration to with autism spectrum disorder (ASD).
Methods:
We electronically searched PubMed, Google Scholar, clinical trial.gov, and Medline Database of clinical studies up to June 2021. We used the following keywords: “bone mineral density, osteoporosis, osteopenia, bone loss, bone changes” AND “antipsychotics, SGAs, atypical antipsychotics” AND “pediatric, adolescent, young, youth, children.” We used [Mesh] Term for “antipsychotics agent” and “bone mineral density” and “autism spectrum disorder” and “child.” We retrieved relevant observational studies, reviews, case series, and randomized clinical trials.
Results:
Yvette Roke et al., in 2012, reported in a retrospective observational study that lumbar spine bone mineral density (BMD) and the biochemical bone marker were lower in the AP-treated boy with hyperprolactinemia in comparison to the non-AP-treated group, while a retrospective observational study of institutional adolescents with a psychiatric condition, carried out by Bonnot et al. in 2011, found significant vitamin D deficiency in psychiatric inpatient adolescents that is unrelated to the specific APs. Third, Calarge et al. in a 2010 retrospective observational study have reported a significant reduction in BMD in adolescents with risperidone-induced hyperprolactinemia and selective serotonin reuptake inhibitor (SSRI) compared to another group with risperidone-induced hyperprolactinemia without SSRI. On the other hand, Nivin A. Nagiub et al. (2019) in the cross-sectional study found no correlation between BMD and AP use in children with ASD. Houghton et al., in 2021, found a high fracture prevalence of 38% with aripiprazole compared to risperidone in children with ASD.

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