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Page: << Prev | 1 | 2 | 3 | Next >> The report was published in the Sept. 15 online edition of The American Journal of Psychiatry.
For the study, Sikich's team randomly assigned 116 children and adolescents aged 8 to 19 to receive the older antipsychotic molindone or the second-generation antipsychotics olanzapine or risperidone. The trial went on for eight weeks.
During that time, all the medications showed a similar decline in symptoms. However, the drugs cause different side effects. Patients taking olanzapine or risperidone experienced significant weight gain, while 40 percent of the patients taking molindone became restless.
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"Olanzapine caused, on average, about 17 pounds of weight gain in eight weeks and rispiridone caused about 12 pounds of weight gain in eight weeks," Sikich said. "Whereas molindone actually caused a very slight weight loss."
Weight gain is a concern, because it is associated with higher risk of diabetes and heart disease and stroke, Sikich said. "With olanzapine, there was an increase in levels of bad cholesterol and an increase in insulin and indications of fat deposits in the liver, which can cause dysfunction, if it persists," she said. "Olanzapine shouldn't be the very first choice."
As a matter of fact, the olanzapine arm of the trial was ended early because of these troubling metabolic effects, according to the researchers.
Patients taking the older drug molindone also had to take another drug called benztropine to reduce muscle cramps and stiffness. Older antipsychotics, such as molindone, can produce Parkinson-like symptoms, such as involuntary movements, which in some patients can lead to permanent physical disabilities.
Beyond the differences between the medications, none of them really work very well, Sikich said. "The kids in the study didn't have a good enough response or had too many side effects to stay on the first medicine they were on."
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