PMID- 31134563
OWN - NLM
STAT- MEDLINE
DCOM- 20191003
LR  - 20200225
IS  - 1179-2019 (Electronic)
IS  - 1174-5878 (Linking)
VI  - 21
IP  - 3
DP  - 2019 Jun
TI  - Safety and Tolerability of Antipsychotic Medication in Individuals with Autism 
      Spectrum Disorder: A Systematic Review and Meta-Analysis.
PG  - 153-167
LID - 10.1007/s40272-019-00333-x [doi]
AB  - BACKGROUND: Antipsychotic medication is a commonly prescribed drug class in 
      individuals with autism spectrum disorder (ASD). However, the safety of these 
      agents has not been fully assessed. OBJECTIVE: Our objective was to investigate 
      the safety and tolerability profile of antipsychotics in individuals with ASD. 
      METHODS: The Cochrane Library, MEDLINE, Embase and PsycINFO databases were 
      searched up to January 2018. We included studies that reported adverse events 
      (AEs) in participants with ASD taking first- or second-generation antipsychotic 
      medication. The studies included in the analysis were randomized controlled 
      trials (RCTs) and observational studies that were comparative or noncomparative 
      and published as full text in the English language. The primary outcome of this 
      review was AEs of any severity reported with antipsychotic use at any dose. 
      Meta-analysis was performed on studies with child and adolescent participants to 
      estimate the pooled prevalence of the overall AEs and the relative risk (RR) of 
      AEs associated with antipsychotic use using a random-effects model. The Cochrane 
      Collaboration tool and the modified Newcastle-Ottawa Scale (NOS) were used to 
      assess the risk of bias of the included RCTs and observational studies, 
      respectively. RESULTS: In total, 54 citations fulfilled the inclusion criteria, 
      of which 40 were RCTs and 14 were observational studies; eight RCTs were included 
      in the meta-analysis to estimate the RR of AEs associated with antipsychotic use 
      and seven observational studies were included to estimate the pooled prevalence 
      of AEs. The RR of AEs with antipsychotic treatment was 22% higher than with 
      placebo (RR 1.22; 95% confidence interval [CI] 1.11-1.34; I(2) = 30.6%; 
      p = 0.184). The estimated pooled prevalence of AEs was 50.5% (95% CI 33-67). The 
      most commonly reported AEs were increased appetite and weight gain, which were 
      associated with discontinuation in many participants. CONCLUSION: 
      Antipsychotic-related AEs were common among patients with ASD. Further studies to 
      investigate the implications of antipsychotic-related AEs on health and 
      medication adherence are warranted. PROSPERO registration number: 
      (CRD42018083632).
FAU - Alfageh, Basmah H
AU  - Alfageh BH
AUID- ORCID: 0000-0003-3051-9017
AD  - School of Pharmacy, University College London, London, UK.
AD  - College of Pharmacy, King Saud University, Riyadh, Kingdom of Saudi Arabia.
FAU - Wang, Zixuan
AU  - Wang Z
AD  - School of Pharmacy, University College London, London, UK.
FAU - Mongkhon, Pajaree
AU  - Mongkhon P
AD  - School of Pharmacy, University College London, London, UK.
AD  - School of Pharmaceutical Sciences, University of Phayao, Muang Phayao, Thailand.
FAU - Besag, Frank M C
AU  - Besag FMC
AUID- ORCID: 0000-0002-4530-7933
AD  - School of Pharmacy, University College London, London, UK.
AD  - East London Foundation NHS Trust, Bedfordshire, UK.
AD  - Maudsley Hospital and Institute of Psychiatry, Psychology and Neuroscience, 
      King's College London, London, UK.
FAU - Alhawassi, Tariq M
AU  - Alhawassi TM
AD  - College of Pharmacy, King Saud University, Riyadh, Kingdom of Saudi Arabia.
AD  - Medication Safety Research Chair, College of Pharmacy, King Saud University, 
      Riyadh, Kingdom of Saudi Arabia.
FAU - Brauer, Ruth
AU  - Brauer R
AD  - School of Pharmacy, University College London, London, UK.
FAU - Wong, Ian C K
AU  - Wong ICK
AUID- ORCID: 0000-0001-8242-0014
AD  - School of Pharmacy, University College London, London, UK. wongick@hku.hk.
AD  - Department of Pharmacology and Pharmacy, University of Hong Kong, Pokfulam, Hong 
      Kong. wongick@hku.hk.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - Switzerland
TA  - Paediatr Drugs
JT  - Paediatric drugs
JID - 100883685
RN  - 0 (Antipsychotic Agents)
SB  - IM
MH  - Adolescent
MH  - Antipsychotic Agents/pharmacology/*therapeutic use
MH  - Autism Spectrum Disorder/*drug therapy/pathology
MH  - Child
MH  - Humans
EDAT- 2019/05/28 06:00
MHDA- 2019/10/08 06:00
CRDT- 2019/05/29 06:00
PHST- 2019/05/28 06:00 [pubmed]
PHST- 2019/10/08 06:00 [medline]
PHST- 2019/05/29 06:00 [entrez]
AID - 10.1007/s40272-019-00333-x [pii]
AID - 10.1007/s40272-019-00333-x [doi]
PST - ppublish
SO  - Paediatr Drugs. 2019 Jun;21(3):153-167. doi: 10.1007/s40272-019-00333-x.