Current strategies for predicting side effects from second generation antipsychotics in youth

Jacob T. Brown, Claudia Campo-Soria, Jeffrey R. Bishop

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations


Introduction: Antipsychotic medications are used to treat a number of conditions in children and adolescents. While side effect profiles from second generation antipsychotics (SGAs) may differ from older antipsychotics, they do not come without risk. Knowing which children may be at higher risk for specific outcomes is important clinical information for prescribers. Common side effects and toxicities of SGAs in children include movement disorders, weight gain, and hormonal changes. There are also rare, but potentially dangerous adverse events including neuroleptic malignant syndrome, hypersensitivity and suicidal ideation. Areas covered: This review will summarize and comment on clinical, pharmacological, and genetic factors having evidence as predictors of SGA-associated side effects and toxicities in children. Expert opinion: Observations across studies note that older children and those that do not respond early in treatment may be more at risk for movement disorders, while younger, antipsychotic naive children are at increased risk for weight gain. Relatively fewer studies have looked at pharmacogenetic relationships, although variations in pharmacokinetic and pharmacodynamic genes hold promise to advance drug dosing or selection strategies. Future efforts to assimilate multiple clinical, pharmacological, and genetic factors to facilitate predictive analytics and clinical decision support for prescribers will advance precision care to patients.

Original languageEnglish (US)
Pages (from-to)655-664
Number of pages10
JournalExpert Opinion on Drug Metabolism and Toxicology
Issue number6
Early online dateMay 2 2021
StatePublished - Jun 2021

Bibliographical note

Publisher Copyright:
© 2021 Informa UK Limited, trading as Taylor & Francis Group.


  • Antipsychotics
  • adverse events
  • children
  • movement disorders
  • pediatrics
  • pharmacogenetics
  • prolactin
  • side effects
  • toxicity
  • weight gain


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