June 22, 2016

Antipsychotic use in childhood could have significant long-term effects

Study reveals potential life-long impacts of early antipsychotic use on depression, anxiety and hyperactivity.  

The use of antipsychotic medication in childhood and the teenage years could have significant long-term impacts on behaviours later in life, particularly in males, a new study has found. 

The research, conducted by neuroscientists at UOW and the Illawarra Health and Medical Research Institute (IHMRI), was recently published in the Journal of Psychopharmacology. It looked at the enduring impacts of three commonly prescribed antipsychotic drugs, Aripiprazole, Olanzapine and Risperidone, on the brains of young healthy rats.

The researchers found long-term alterations to a number of adult behaviours, including changes to activity levels as well as changes in depressive-like behaviours and anxiety levels.   

PhD student Michael De Santis (pictured above), an Australian Rotary Health scholarship recipient from the Antipsychotic Research Laboratory and the School of Medicine, who led the study, said the drugs had a more profound impact on male rats. 

“In comparison to a control group, male rats that were given Risperidone were much more likely to exhibit hyperactive behaviour in adulthood, while those given Olanzapine demonstrated behaviours indicative of a lowered depressive-like behaviour, and all three drugs led to the expression of anxiety-like behaviours later in life. 

“Conversely, we found that female rats given Aripiprazole and Olanzapine were more likely to display behaviours indicative of a depressive-like state as adults. However, the overall impacts on female rats were much less prominent than in the male cohort.” 

Professor Chao Deng, Head of the Antipsychotic Research Laboratory at IHMRI, said although antipsychotics are reasonably effective in controlling the short-term symptoms of mental disorders in children and adolescents, not a lot is known about the long-term impacts. 

“This study revealed that early exposure to antipsychotics, to such potent drugs in a period of time where critical neurodevelopmental changes are occurring, might have long-term effects on adult behaviour.” 

“In other words, we may be seeing changes in behaviour because early antipsychotic use is potentially causing long-term alterations to the development of critical neurotransmitter systems in the brain.” 

The prescription of antipsychotics to children has increased exponentially in recent years, many of which were “off-label”, meaning they were prescribed to those who did not fit the recommended guidelines. 

Professor Deng said while it may be appropriate that antipsychotics are prescribed to those with severe mental illnesses such as schizophrenia and bipolar disorder, many children are also prescribed antipsychotics for conditions such as autism, obsessive compulsive disorder, and to control some of the symptoms of ADHD, which have not been approved under Australian Government regulations.  

“We hope this study will help fill the critical knowledge gap in this area and assist paediatricians and psychiatrists prescribing antipsychotics -- so they can weigh-up the risks versus the benefits of prescribing these drugs in such a critical time period.” 

Professor Deng and his team are now looking at the impacts of early antipsychotic use on the neurotransmitter systems dopamine and serotonin, which among other important functions, influence mood, behaviour and learning.   

This research is part of a larger NHMRC project at UOW, initiated and led by Professor Deng, to investigate the long-term effects of early antipsychotic exposure in children and adolescents on brain function, adult behaviours and metabolisms.