Apports des données en vie réelle à la sécurité des antipsychotiques chez l’enfant et l’adolescent

Abstract

The use of antipsychotics (APs) in child and adolescent psychiatry poses major challenges, both in terms of iatrogenesis and drug abuse. Analyzing real-world data from the international pharmacovigilance database (VigiBase®) revealed age-dependent safety profiles with increased reports of alertness disorders, seizures, and aggression in young children, while adolescents were subject to higher rates of depression, abuse, and dependence. Risperidone, aripiprazole, quetiapine, and olanzapine were the most frequently implicated antipsychotics, with olanzapine associated with catatonia and quetiapine notably linked to abuse in adolescents. Nutritional disorders related to antipsychotics were more frequently reported in children and adolescents, with risperidone showing a high disproportionality signal. Adolescents exhibited specific safety concerns, including a signal for non-alcoholic steatohepatitis associated with aripiprazole. Despite the limitations of pharmacovigilance methods, these studies help quantify adverse drug event frequencies in specific subgroups and detect emerging or rare signals. These pharmacoepidemiological analyses emphasize the importance of rigorous, ongoing benefit-risk assessment when prescribing antipsychotics in the pediatric population.