Metabolic Changes From Antipsychotic Medications in Youth

Node Smith, ND


A new study reveals that short-term treatment of children with antipsychotic medications can increase body fat, and decrease insulin sensitivity, predisposing these children to the development of diabetes.1


Childhood obesity is now considered an epidemic


Childhood obesity has increased by more than 300 percent from the 1970's to now, and is considered an epidemic that is contributing to the rising rates of diabetes in youth. There is also an increased practice of using antipsychotic medications in an off-label way to treat common nonpsychotic behavioral problems, such as attention deficit hyperactivity disorder (ADHD). The use of these drugs, even for a short time, may be changing the metabolisms of children in way that makes them gain weight easier and develop insulin resistance.


First study of its kind


Researchers from Florida Atlantic University and Washington University in St. Louis, have published a randomized prospective clinical trial testing the hypothesis that antipsychotic medications adversely affect body fat and insulin resistance. Children between the ages of 6 and 18 were analyzed. It is already known that antipsychotic medications are linked to diabetes development, as well as weight gain, but there have yet to be any studies on children. The study is published in JAMA Psychiatry.


First time whole body changes have been measured in a population taking antipsychotics


The interesting thing about this study is that it is the first time that whole body changes have been measured in a population taking antipsychotics for the first time.


The study


The study looked at 144 children, all of whom were diagnosed with at least one psychiatric condition involving significant aggression and for which antipsychotic medication was already being considered. Participants were randomly assigned to 1 of 3 different medications (aripiprazole, olanzapine, or risperidone) for 12 weeks.


All of the medications resulted in significant increases in body fat


All of the medications resulted in significant increases in body fat, including both visceral and subcutaneous abdominal fat, which are more closely associated with risks for cardiovascular disease, high blood pressure and diabetes. Insulin sensitivity was also altered significantly


The U.S. has seen a surge in off label use of antipsychotic meds


Over the past twenty years the United States has seen a significant increase in the off label use of antipsychotic medication for behavioral conditions. These drugs were not developed for this use, and are now being shown to have adverse effects that may outweigh their proposed benefits of off-label use.


Source:



Nicol GE, Yingling MD, Flavin KS, et al. Metabolic Effects of Antipsychotics on Adiposity and Insulin Sensitivity in Youths: A Randomized Clinical Trial.JAMA Psychiatry. 2018 Jun 13. doi: 10.1001/jamapsychiatry.2018.1088. [Epub ahead of print] PMID:29898210

Photo by Caroline Hernandez on Unsplash



Node Smith, ND, is a naturopathic physician in Portland, OR and associate editor for NDNR. He has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine among the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend camp-out where naturopathic medicine and medical philosophy are experienced in nature. Four years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision.


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