Complications of Antipsychotic Therapy in Children With Tourette Syndrome

Antipsychotics are effective at suppressing tics in Tourette syndrome, but can cause side effects. At a single center, all children with Tourette syndrome requiring antipsychotics were systematically monitored for metabolic and neurologic side effects every 6 months. Seventy-three children were followed for a mean of 39.6 months. Most children were treated primarily with an atypical antipsychotic. Thirty-three of 73 children (45%) developed lipid abnormalities. Compared with population-based mean lipid values for boys, total cholesterol, low-density lipoprotein, high-density lipoprotein, and triglyceride levels were significantly higher in our male sample (P < 0.0001). Girls had significantly lower high-density lipoprotein concentrations (P = 0.0033). Thirty-six of 73 (49%) children demonstrated abnormal body mass index percentiles. The odds of having lipid abnormalities were significantly higher in children with abnormal body mass indices (odds ratio, 6.0; 95% confidence interval, 2.15-16.7; P = 0.0004). Three of 73 children developed neurologic complications. Metabolic complications of antipsychotics are common in children. These findings underscore the need to discuss benefits and risks before initiating therapy, and the importance of routinely monitoring growth and lipid profiles. Neurologic complications are uncommon, which is likely attributable to the primary use of atypical antipsychotics in this setting.