Iron homeostasis during risperidone treatment in children and adolescents.
Iron homeostasis during risperidone treatment in children and adolescents.
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DOI：
10.4088/jcp.14m09258
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发表时间：
2015-11
期刊：
影响因子：
--
通讯作者：
Arnold LE
中科院分区：
文献类型：
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作者：
Calarge CA;Ziegler EE;Del Castillo N;Aman M;McDougle CJ;Scahill L;McCracken JT;Arnold LE
Previous cross-sectional evidence has linked antipsychotic-related weight gain to reduced body iron concentration. Using longitudinal data, we examined the association between changes in weight following risperidone initiation or discontinuation and ferritin concentration. Study 1: Between 04/2004 and 09/2007, participants were enrolled in a prospective randomized clinical trial comparing the efficacy of risperidone monotherapy to the combination of risperidone and behavior therapy in targeting disruptive behavior in 4 to 13 year-old children with DSM-IV-TR-based autism spectrum disorder. Study 2: Medically healthy 7 to 17 year-old participants in long-term open-label risperidone treatment at study entry returned for follow up 1.5 years later, between 07/2007 and 07/2011. Available blood samples were used to measure ferritin. Linear multivariable regression analysis tested the association between ferritin concentration and change in age-sex-specific body mass index (BMI) Z-score between study entry and endpoint, adjusting for relevant confounders. Study 1 sample consisted of 73 participants (85% males, mean age: 7.7±2.4 years). After 18.0±2.0 weeks on risperidone, their BMI Z-score increased by 0.93±0.70 points and ferritin concentration declined by 6.8±13.3 μg/L. After adjusting for age and sex, change in BMI Z-score was inversely correlated with percent change in ferritin concentration (β= −18.3, p<0.003). Study 2 participants had all been receiving risperidone at study entry. At follow up, 1.5±0.3 years later, risperidone was discontinued in 26 of the 96 who were included in the analysis. Neither change in BMI Z-score nor in ferritin concentration was different between those who continued vs. discontinued risperidone. However, a reduction in BMI Z-score between study entry and follow up was associated with higher ferritin concentration at follow up in participants who discontinued risperidone compared to those who continued it (p=0.01). Risperidone-related weight gain is associated with a reduction in body iron reserves, which appears to improve with weight loss following risperidone discontinuation. Preliminary evidence suggests that risperidone may also directly inhibit iron absorption. Study 1: on clinicaltrials.gov. Study 2: Not applicable.
