PhD defence: Monitoring for adverse drug reactions in children and adolescents treated with antipsychotic drugs

Children and adolescents treated with antipsychotic drugs can experience severe and bothersome adverse drug reactions, which can have a physical as well as an emotional impact on their lives. It is important to monitor these children and adolescents closely so that adverse drug reactions are identified early. This thesis assessed the daily practice of monitoring for adverse drug reactions in children and adolescents treated with antipsychotic drugs, and what could be improved.

Many different adverse drug reactions with antipsychotic treatment are reported by young people and healthcare professionals, including weight gain, breast enlargement, and movement disorders. How adverse drug reactions are monitored was studied in various ways: questionnaires were completed by Dutch child and adolescent psychiatrists, medical records of an organization for child and adolescent psychiatry were examined, and prescription data from British general practitioners were analyzed. In none of these studies monitoring was optimal and it varied between healthcare professionals. Healthcare professionals rarely report the reason for not monitoring and guidelines are most often not completely followed. There are clinical guidelines on how to monitor for adverse drug reactions. However, these guidelines differ in what and how often to monitor and are not always easily applicable in daily practice. Furthermore, providing support to children and adolescents treated with antipsychotic drugs is essential. Adolescents who were interviewed regarding the support provided emphasized the importance of personal guidance and involvement in decision-making.

Better monitoring is important to ensure a safe and effective antipsychotic drug treatment for this vulnerable group.