Abstract
Introduction: Atypical antipsychotics like quetiapine, can cause undesirable alterations in lipid profile and hyperglycemia. They are associated with metabolic and cardiovascular related adverse events in pediatric population, especially when multiple antipsychotics or classes of psychotropic medications are co prescribed. Case Report: A 15yearold, overweight, Hispanic male child was referred to the endocrinology clinic by his primary care provider due to high serum cholesterol, triglyceride and glucose levels. Past history was significant for autism, anxiety with depression and attention deficit disorder for which he was getting psychiatric care and was receiving quetiapine 50 mg daily for more than two years. Physical examination was significant for increased adiposity and overweight. Fasting laboratory studies showed elevated cholesterol and triglycerides. In addition to lifestyle modification including diet and exercise, quetiapine was discontinued and replaced by aripiprazole. Repeat testing after four months showed normalized cholesterol and triglyceride levels. Conclusion: The use of atypical antipsychotics prescribed to children and adolescents with neuropsychiatric disorders has been associated with various adverse effects, including significant weight gain. These adverse effects are of particular concern in children and adolescents due to the immediate and long term health risks associated with weight gain, including obesity, diabetes mellitus and hyperlipidemia.
Highlights
Medications such as a typical antipsychotics, like quetiapine can cause undesirable alterations in lipid profile and hyperglycemia. Adverse metabolic effects such as diabetes mellitus, lipid abnormalities and weight gain have increasingly been recognized with the use of the newer, socalled atypical antipsychotic drugs
Their profile of potent antagonism at specific serotonin and dopamine receptors offers certain advantages compared with typical antipsychotics, their use has been associated with various adverse effects, including significant weight gain
Mean weight gain over the 8 week openlabel trial was 3.4 kg [6]. This adverse effect is of particular concern in children and adolescents, secondary to the immediate and long term health risks associated with weight gain, including obesity, diabetes mellitus, and hyperlipidemia [11, 7, 8]
Summary
Medications such as a typical antipsychotics, like quetiapine can cause undesirable alterations in lipid profile and hyperglycemia Adverse metabolic effects such as diabetes mellitus, lipid abnormalities and weight gain have increasingly been recognized with the use of the newer, socalled atypical antipsychotic drugs. Www.ijcasereportsandimages.com of cases between the development of new onset Type2 diabetes mellitus and elevated serum triglyceride (TG) levels, often with reversal of these problems upon discontinuation of the offending agent [6,7,8]. The laboratory tests repeated four months later showed normalizing serum cholesterol of 209 mg/dL, triglycerides 261 mg/dL, HDL 44 mg/dL, LDL 113 mg/dL, AST 46 IU/dL and ALT 68 IU/dL with normal amylase, lipase, thyroid stimulating hormone and fasting insulin levels
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