Assessment of the effectiveness and side effects of antipsychotic treatment in children and adolescents initiated on psychiatric outpatient clinic admissions

Aim: The study was aimed to assess the effectiveness and side effects of antipsychotic treatment in children and adolescents aged 6-18 who initiated antipsychotic treatment at the child and adolescent psychiatry outpatient clinic. Materials and Methods: During a one-year period, 98 children and adolescents who initiated antipsychotic treatment and had complete data were included in the study at the child and adolescent psychiatry outpatient clinic. The effects were evaluated using CGI-S, CDRS, SCARED, Turgay, YMRS, SAPS-SANS, ABC, NSESSS scales, while side effects were assessed using the UKU and LUNSERS scales. Medication administrations, anthropological measurements, laboratory studies and side effects of the patients at their 0th, 3rd and 6th month follow-up visits were evaluated. Results: The most common diagnoses for which antipsychotic medications were initiated were MDD (34.7%), CD (22.4%), ADHD (8.2%) and BD (18.4%). It was observed that 54.1% (n=53) of APs were risperidone, 25.5% (n=25) aripiprazole, 13.3% (n=13) olanzapine, 7.1% (n=7) quetiapine. In a 6-month period, risperidone and aripiprazole had similar efficacy in MDD, ADHD and CD (respectively, p=0.168, (Inattention p=0.760, Hyperactivity p=0.287, Impulsivity p=0.681), p=0.279), while olanzapine was more effective than risperidone for BD (p=0.021). Olanzapine has a greater effect on increasing weight (p<0.001), BMI (p<0.001) and HOMA-IR (p=0.030) levels. Statistically significant changes were observed in the lipid profile, thyroid and kidney function of patients using risperidone, aripiprazole and olanzapine. Risperidone and olanzapine increased blood prolactin, while aripiprazole decreased it. The most common side effects across all drug groups were weight gain and increased sleep. Side effects were more severe in individuals over 12 and in females. Conclusion: Antipsychotics were found to effectively reduce the severity of mental disorders. However, prolonged usage in this age group may lead to adverse outcomes, especially concerning endocrine and metabolic functions. It is important to consider low-risk alternatives in antipsychotic use and to regularly monitor patients. Key words: Antipsychotic, aripiprazole, quetiapine, olanzapine, risperidone.