Risks and benefits of antipsychotics in children and adolescents

Many of the psychiatric disorders observed in adults have their onset in childhood or adolescence. In fact some studies show that at least 20% of children and adolescents will fulfil a diagnostic criterion for a mental disorder before reaching adulthood. The presence of a major mental illness is certainly no less serious in children than in adults – in fact, childhood onset of several psychiatric disorders predicts a worse illness course. Early manifestations of mental disorders may substantially impact the child´s academic performance and achievement as well as his/her ability to develop age-appropriate social skills. Thus, appropriate identification and treatment of signs and symptoms of psychiatric illnesses during childhood and adolescence is critical for minimizing continued or additional psychiatric problems that put these children at risk later in life.

For many years old antipsychotics have been used for the treatment of conditions such as severe conduct disorders, Tourette syndrome, bipolar disorder and schizophrenia in children and adolescents. Treatment advances, particularly with the introduction of new-generation antipsychotic medications, have created a lot of expectations in the search for long-term, clinically effective treatments for this young population. The prescription of new-generation antipsychotics has become a widely accepted practice in the treatment of children and adolescents with psychotic disorders (Armenteros & David, 2006) and many other psychiatric conditions (Findling et al., 2005; Olfson et al., 2006). In fact, prescribing of new-generation antipsychotics has increased dramatically in recent years in the paediatric population (160% in the USA between 1990 and 2000) (Patel et al., 2005).

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