Activation in Children and Adolescents Treated With Selective Serotonin Reuptake Inhibitors: A Weighty Reason?

J Clin Psychopharmacol. 2018 Oct;38(5):475-480. doi: 10.1097/JCP.0000000000000923.

Abstract

Background: Activation is a behavioral adverse event related to the use of psychotropic medication. Its high incidence in pediatrics and in childhood-onset neuropsychiatric disorders suggests it may be linked to neurodevelopment. However, previous studies have scarcely examined the role that factors relevant to developmental pharmacokinetics, such as body weight, may play in the onset of activation in children and adolescents.

Methods: We conducted a retrospective analysis of hospitalized patients to identify the risk factors for activation in children and adolescents treated with selective serotonin reuptake inhibitors. Our focus was on factors related to development, including body weight, to explore the relationship between activation and neurodevelopmental processes.

Results: Among the 139 participants (mean age, 14 ± 2.3 years), activation appeared in 29 (20.9%). Age 12 years or younger and comorbid diagnosis of autism spectrum disorder were associated with statistically significant increases in the risk of activation, but no association was found regarding body weight.

Conclusions: Our findings support the hypothesis that activation is closely linked to brain development processes. Longitudinal studies are needed to explore this line of research further.

MeSH terms

  • Adolescent
  • Akathisia, Drug-Induced / metabolism
  • Akathisia, Drug-Induced / psychology
  • Body Weight / drug effects
  • Body Weight / physiology*
  • Child
  • Female
  • Follow-Up Studies
  • Humans
  • Irritable Mood / drug effects
  • Irritable Mood / physiology
  • Male
  • Neurodevelopmental Disorders / drug therapy*
  • Neurodevelopmental Disorders / metabolism
  • Neurodevelopmental Disorders / psychology*
  • Retrospective Studies
  • Risk Factors
  • Selective Serotonin Reuptake Inhibitors / adverse effects*
  • Selective Serotonin Reuptake Inhibitors / therapeutic use
  • Self-Injurious Behavior / chemically induced
  • Self-Injurious Behavior / metabolism
  • Self-Injurious Behavior / psychology
  • Treatment Outcome

Substances

  • Serotonin Uptake Inhibitors