Risperidone versus aripiprazole fracture risk in children and adolescents with autism spectrum disorders

Houghton, Richard; Bergh, Joop van den; Law, Kiely; Liu, Yutong; Vries, Frank de

doi:10.1002/aur.2541

Cited by 5 publications

(10 citation statements)

References 54 publications

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“…12 Houghton et al found, in 2021, aripiprazole has a higher fracture prevalence in ASD children compared to risperidone. 13 A retrospective observational study between 2013 and 2018 includes 6624 children, aged 2 to 18 years, with ASD and on AP either risperidone or aripiprazole. 13 Fracture incidence was 23.2% with risperidone compared to 38.4% with aripiprazole.…”

Section: Resultsmentioning

confidence: 99%

“…13 A retrospective observational study between 2013 and 2018 includes 6624 children, aged 2 to 18 years, with ASD and on AP either risperidone or aripiprazole. 13 Fracture incidence was 23.2% with risperidone compared to 38.4% with aripiprazole. 13…”

Section: Resultsmentioning

confidence: 99%

“…12 While Houghton et al (2021) found that the bone fracture prevalence with risperidone is 40% less than aripiprazole in children with ASD. 13 The incidence was 23.2% for risperidone vs. 38.4% for aripiprazole. 13 The AP has multiple mechanisms of affecting bone metabolism and mineral density.…”

Section: Discussionmentioning

confidence: 97%

“…9, 11 Fracture prevalence correlates positively with the use of AP in ASD patients as reflected in the study done by Houghton and his colleagues with prevalence reaching 38.4% with aripiprazole. 13 While, the other study evaluates bone cortical thickness in children with ASD (mean age 7 years, n = 75) measured on a hand and wrist compared to the normal group; the boys with ASD had reduced bone cortical thickness. 9, 11 Despite low BMD in ASD patients, the fracture prevalence rate is less, but a fracture in psychiatric patients carries high morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

“…11 Another controversial point that needs further study is whether the changes in BMD are caused by AP or triggered by an underlying psychiatric condition such as schizophrenia. 13, 14…”

Section: Discussionmentioning

confidence: 99%

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Review of the Long-Term Effect of the Atypical Antipsychotic Medication on the Bone Mineral Density of the Pediatric Patient with Consideration of Autism Spectrum Disorder

Jumaili

Muzwagi

2022

Journal of Pharmacology and Pharmacotherapeutics

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Objectives: To shed some light on the understudied complication of chronic prolonged exposure to antipsychotics (AP) in children with consideration to with autism spectrum disorder (ASD). Methods: We electronically searched PubMed, Google Scholar, clinical trial.gov, and Medline Database of clinical studies up to June 2021. We used the following keywords: “bone mineral density, osteoporosis, osteopenia, bone loss, bone changes” AND “antipsychotics, SGAs, atypical antipsychotics” AND “pediatric, adolescent, young, youth, children.” We used [Mesh] Term for “antipsychotics agent” and “bone mineral density” and “autism spectrum disorder” and “child.” We retrieved relevant observational studies, reviews, case series, and randomized clinical trials. Results: Yvette Roke et al., in 2012, reported in a retrospective observational study that lumbar spine bone mineral density (BMD) and the biochemical bone marker were lower in the AP-treated boy with hyperprolactinemia in comparison to the non-AP-treated group, while a retrospective observational study of institutional adolescents with a psychiatric condition, carried out by Bonnot et al. in 2011, found significant vitamin D deficiency in psychiatric inpatient adolescents that is unrelated to the specific APs. Third, Calarge et al. in a 2010 retrospective observational study have reported a significant reduction in BMD in adolescents with risperidone-induced hyperprolactinemia and selective serotonin reuptake inhibitor (SSRI) compared to another group with risperidone-induced hyperprolactinemia without SSRI. On the other hand, Nivin A. Nagiub et al. (2019) in the cross-sectional study found no correlation between BMD and AP use in children with ASD. Houghton et al., in 2021, found a high fracture prevalence of 38% with aripiprazole compared to risperidone in children with ASD. Conclusion: Clinicians should be aware of the potential negative effects of APs on BMD, considerably in children with ASD that has additional risk factors for osteoporosis and bone disease. A provider needs to utilize more sensitive screening and diagnostic tools; the pediatric physician should evaluate other risk factors to prevent early osteopenia and bone fracture in children with ASD who are on chronic psychotropic medication, before adjusting to the AP medication.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

“…11 Another controversial point that needs further study is whether the changes in BMD are caused by AP or triggered by an underlying psychiatric condition such as schizophrenia. 13, 14…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Review of the Long-Term Effect of the Atypical Antipsychotic Medication on the Bone Mineral Density of the Pediatric Patient with Consideration of Autism Spectrum Disorder

Jumaili

Muzwagi

2022

Journal of Pharmacology and Pharmacotherapeutics

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Dietary nutrients that potentially mitigate autism spectrum disorder and dietary recommendations for children and pregnant women

Li,

Kong,

Tian

et al. 2024

Food Frontiers

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The increasing incidence of autism spectrum disorder (ASD) worldwide poses serious social and family problems. Various risk factors for ASD are gradually being recognized, and there are also various options for the treatment of ASD. It is worth noting that dietary interventions have been shown to have a positive effect in terms of mitigating and preventing some psychiatric disorders, such as epilepsy, Parkinson's disease, and ASD, and they are gradually receiving attention as a safe adjuvant treatment. In this review, based on the current understanding of the pathogenic factors and intervention strategies for ASD, different dietary patterns that can be selected for children with ASD are discussed in depth. Moreover, a review was conducted on the use of dietary factors, such as natural products from food sources, prebiotics, and probiotics, as effective supplements to existing dietary patterns. As increasing evidence shows that maternal risk factors, such as obesity, diabetes, and hypertension, are associated with an increased risk of ASD in offspring, dietary suggestions are also made for pregnant woman with ASD‐related risk factors to counteract the impact of these risk factors. With compensation from food‐derived natural products, prebiotics, and probiotics, suitable dietary patterns can further enhance the effectiveness of dietary interventions for ASD. In addition, dietary recommendations for pregnant woman may reduce the potential impact of obesity, diabetes, and hypertension and may help to prevent the occurrence of ASD to the maximum extent possible.

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The trilateral interactions between mammalian target of rapamycin (mTOR) signaling, the circadian clock, and psychiatric disorders: an emerging model

2022

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Circadian (~24 h) rhythms in physiology and behavior are evolutionarily conserved and found in almost all living organisms. The rhythms are endogenously driven by daily oscillatory activities of so-called “clock genes/proteins”, which are widely distributed throughout the mammalian brain. Mammalian (mechanistic) target of rapamycin (mTOR) signaling is a fundamental intracellular signal transduction cascade that controls important neuronal processes including neurodevelopment, synaptic plasticity, metabolism, and aging. Dysregulation of the mTOR pathway is associated with psychiatric disorders including autism spectrum disorders (ASD) and mood disorders (MD), in which patients often exhibit disrupted daily physiological rhythms and abnormal circadian gene expression in the brain. Recent work has found that the activities of mTOR signaling are temporally controlled by the circadian clock and exhibit robust circadian oscillations in multiple systems. In the meantime, mTOR signaling regulates fundamental properties of the central and peripheral circadian clocks, including period length, entrainment, and synchronization. Whereas the underlying mechanisms remain to be fully elucidated, increasing clinical and preclinical evidence support significant crosstalk between mTOR signaling, the circadian clock, and psychiatric disorders. Here, we review recent progress in understanding the trilateral interactions and propose an “interaction triangle” model between mTOR signaling, the circadian clock, and psychiatric disorders (focusing on ASD and MD).

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Risperidone versus aripiprazole fracture risk in children and adolescents with autism spectrum disorders

Cited by 5 publications

References 54 publications

Review of the Long-Term Effect of the Atypical Antipsychotic Medication on the Bone Mineral Density of the Pediatric Patient with Consideration of Autism Spectrum Disorder

Review of the Long-Term Effect of the Atypical Antipsychotic Medication on the Bone Mineral Density of the Pediatric Patient with Consideration of Autism Spectrum Disorder

Dietary nutrients that potentially mitigate autism spectrum disorder and dietary recommendations for children and pregnant women

The trilateral interactions between mammalian target of rapamycin (mTOR) signaling, the circadian clock, and psychiatric disorders: an emerging model

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