Section - CAP Smart Takes

05. Efficacy and Tolerability of Antipsychotics for Juvenile Psychotic Disorders

Published on June 1, 2023 Certification expiration date: June 1, 2026

David R. Rosenberg, M.D.

Chair of the Department of Psychiatry & Behavioral Neuroscience - Wayne State University School of Medicine

Key Points

Most antipsychotics were reasonably well-tolerated short term, with clozapine, molindone, olanzapine, and risperidone being most effective in reducing psychotic symptoms in the short term.
Lurasidone was the only antipsychotic effective long term; it also had a lower risk of weight gain and was well-tolerated.

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Text version

Hi! David Rosenberg here for the Psychopharmacology Institute. In this CAP—or Child and Adolescent Psychiatry—Smart Take, we will closely examine both the short- and long-term efficacy and tolerability of antipsychotics in youth with psychosis. This is so important, as considerable challenges remain in treating youth with psychosis adequately. The medicines are often needed long term, with many having significant and problematic side effects.

Yee and colleagues do an excellent job doing a critical analysis of the available published data comparing the efficacy and tolerability of antipsychotics short and long term for youth with psychosis despite the obvious multiple limitations—namely, minimal evidence for the long-term use of antipsychotics in youth with psychosis and few trials for certain antipsychotics. For example, there was only 1 each for short-term trials of aripiprazole, asenapine, lurasidone, molindone, and paliperidone, and only 1 each for long-term trials of aripiprazole, clozapine, haloperidol, lurasidone, and molindone. There was

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Learning Objectives:

Understand the association between sleep disturbances and increased risk of injury and suicidality in children and adolescents.
Understand the racial and ethnic disparities in psychotropic medication prescribing among pediatric patients and recognize the importance of addressing these disparities in clinical practice.
Evaluate the potential benefits and risks of cariprazine as a treatment option for pediatric patients with schizophrenia and bipolar I disorder.
Understand the impact of stimulant medication on growth trajectories in children with ADHD and the factors that can influence this impact, such as race and total stimulant exposure.
Describe the short- and long-term efficacy and tolerability of antipsychotic medications in youth with psychosis.

Original Release Date: June 1, 2023

Review and Re-release Date: March 1, 2024

Last Review Date: April 1, 2026

Expiration Date: June 1, 2026

Expert: David Rosenberg, M.D.

Medical Editor: Lorena Rodriguez, M.D.

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Contact Information: For questions regarding the content or access to this activity, contact us at support@psychopharmacologyinstitute.com

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Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.