Cardiac and metabolic safety profile of antipsychotics in youths: A WHO safety database analysis.

Autor: Merino D; University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice, CHU-Lenval, Nice, France; Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital CHU de Nice, Nice, France; Université Côte d'Azur, CoBTeK, Nice, France., Gérard AO; Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital CHU de Nice, Nice, France; Université Côte d'Azur, Laboratory of Molecular Physio Medicine (LP2M), UMR 7370, CNRS, Nice, France., Destere A; Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital CHU de Nice, Nice, France; Université Côte d'Azur, Inria, CNRS, Laboratoire J.A. Dieudonné, Maasai team, Nice, France., Saidessalam H; Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital CHU de Nice, Nice, France., Askenazy F; University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice, CHU-Lenval, Nice, France; Université Côte d'Azur, CoBTeK, Nice, France., Montastruc F; Department of Medical and Clinical Pharmacology, Centre of PharmacoVigilance and Pharmacoepidemiology, Faculty of Medicine, Toulouse University Hospital, Toulouse, France., Drici MD; Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital CHU de Nice, Nice, France., Thümmler S; University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice, CHU-Lenval, Nice, France; Université Côte d'Azur, CoBTeK, Nice, France. Electronic address: susanne.thummler@univ-cotedazur.fr.
Jazyk: angličtina
Zdroj: Psychiatry research [Psychiatry Res] 2024 Apr; Vol. 334, pp. 115786. Date of Electronic Publication: 2024 Feb 14.
DOI: 10.1016/j.psychres.2024.115786
Abstrakt: A significant heterogeneity prevails in antipsychotics (APs) safety monitoring recommendations. Youths are deemed more vulnerable to cardiometabolic side effects. We aimed to assess age-dependent reporting of cardiac and metabolic disorders in youths, relying on the WHO safety database (VigiBase®). VigiBase® was queried for all reports of cardiac, glucose, lipid and nutritional disorders involving APs. Patients <18 years were classified as pediatric population. Disproportionality analyses relied on the Information Component (IC): the positivity of the lower end of its 95 % confidence interval was required to suspect a signal. We yielded 4,672 pediatric reports. In disproportionality analysis, nutritional disorders were leading in youths (IC 3.9 [3.9-4.0]). Among healthcare professionals' reports, stronger signals were detected in youths than in adults. Children had the greatest signal with nutritional disorders (IC 4.7 [4.6-4.8]). In adolescents, aripiprazole was ascribed to non-alcoholic steatohepatitis (NASH). Our findings, based on real-world data, support the hypothesis of a greater propensity for nutritional disorders in youths, despite limitations of pharmacovigilance studies. We suggest specific safety profiles, such as aripiprazole and NASH. Pending more answers from population-based studies, a careful anamnesis should seek for risk factors before AP initiation. A cautious monitoring is warranted to allow earlier identification of side effects.
Competing Interests: Declaration of competing interest None.
(Copyright © 2024. Published by Elsevier B.V.)
Databáze: MEDLINE
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