Secondary effects of antipsychotic treatment in naive or quasi-naive children and adolescents: Design of a follow-up protocol and baseline results

Introduction. The prescribing of anti-psychotic drugs has become a normal clinical practice. Methods. This article presents a longitudinal, multicentre 12-months-long study conducted on 266 children and adolescents who were prescribed a first or second generation antipsychotic drug for the first time, and the baseline results of the study. The follow-up protocol had its purpose to detect the possible appearance of metabolic, cardiological, and motor changes. Results. When the presence of side effects was evaluated using the UKU (clinical side-effects scale) statistically significant differences were found between naïve (patients who had never taken an anti-psychotic drug) and quasi-naïve patients (those who have taken anti-psychotic drugs for a period of less than 30 days), with a greater number of the latter showing symptoms of: anxiety/laxity/tiredness (P=0.0049), drowsiness/sedation (P<0.001), increase in dream duration (P<0.001), increase in dreams (P=0.0199), emotional indifference (P=0.0194), hypokinesia/akinesia (P=0.0224), paresthesias (P=0.0049), accommodation disorder (P=0.0254), increase in salivation (P<0.001), polyuria/polydipsia (P=0.0076), increase in sweating (P=0.0076), increase in sexual desire (P=0.0117), decrease in sexual desire (P=0.0053), tension headaches (P=0.0405). When the presence of extrapyramidal symptoms was assessed using the MPRC-IMS (Maryland Psychiatry Research Center-Involuntary Movement Scale), it was observed that the quasi-naïve patients had a statistically higher number of dyskinesia (P=0.002), Parkinsonism (P=0.0004) and akathisia (P=0.0437) symptoms compared to the naïve patients. Conclusions. These results show that, in the childhood-adolescent population, the presence of secondary effects begins to be observed from the first dose of the antipsychotic drug(AU)