A recently-published Canadian study involving children and teens indicates that the use of antipsychotic medications such as Abilify and Risperdal can lead to serious weight problems as early as age two. In the retrospective study (one that investigates past data), researchers examined the records of 147 children between the ages of 10 and 16 who had been treated in a Quebec hospital from 2005 to 2013.

The subjects were involved in a program several years ago, designed to study and track the effects of “second-generation anti-psychotics” (SGAs) on the metabolism of young people being medicated with such drugs for the first time. Researchers from the University of Montreal gathered records of patients’ height, weight and bloodwork, examining data on side effects when a single medication was used, then comparing that data with what happened when a patient was given a different medication or a combination of different SGAs. Typically, these children had ADHD and had been diagnosed with “disruptive behavior disorders.”

What the researchers discovered was troubling. After two years, the children in the study had gained an average of 28 pounds. Of those, nearly a quarter wound up seriously overweight, while 10 percent developed impaired fasting glucose – a precursor to Type 2 diabetes. One of the children became diabetic. What was of particular concern to the researchers is that weight gain occurred regardless of which SGAs were being prescribed.

What is not understood is why SGAs cause weight gain in the first place. An earlier study that looked into the overall association between SGAs and weight gain suggested that such medications may affect the production of leptin, a hormone that regulates food intake and metabolism.

Pediatric endocrinologist and diabetic specialist Dr. Constadina Panagiotopoulos observed that children medicated with SDAs often developed a sudden craving for sweets. “Families tell me their kid went from drinking several litres of water to wanting to drink several liters of pop,” she said. However, her own research shows that a child’s actual caloric intake by itself doesn’t account for the entire problem. There is some speculation that the medication may act to slow a patient’s metabolism, causing them to burn fewer calories.

Dr. Panagiotopoulos recommends that children being medicated with SGAs be carefully monitored, undergoing regular checkups. Unfortunately, this does not always happen. “Often these kids will stay on these medications for years, and not be reviewed. We’ve had kids on them for over seven years,” she says.

There is another aspect to this issue, having to do with the greed and carelessness of the pharmaceutical industry. Dr. Allen Frances, a retired professor from Duke University, says SGAs are “wildly and recklessly overused, very often by primary care doctors with little expertise, or time, under the influence of drug company aggressive marketing.” He adds that such medications are often pushed on the children of low-income families as well as those in foster care as a “form of social control.”

Both Panagiotopoulos and Allen acknowledge that there are some children whose behavior is such that solutions such as counseling and behavior modification therapies are ineffective. In such cases, Frances says, “[the use of] medication may be worth it, despite all the risks.” However, he cautions that SGA drugs “should be a very last resort, not a first reflex.”

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K.J. McElrath is a former history and social studies teacher who has long maintained a keen interest in legal and social issues. In addition to writing for The Ring of Fire, he is the author of two published novels: Tamanous Cooley, a darkly comic environmental twist on Dante’s Inferno, and The Missionary’s Wife, a story of the conflict between human nature and fundamentalist religious dogma. When not engaged in journalistic or literary pursuits, K.J. works as an entertainer and film composer.