Systematic review and meta-analysis of weight gain and metabolic changes in children and adolescents using second-generation antipsychotics

The use of second-generation antipsychotics in children and adolescents has significantly increased in recent decades, raising concerns about side effects such as weight gain, dyslipidemia, and insulin resistance. These effects are concerning during development, as they may predispose individuals to adult obesity and metabolic complications. Therefore, the aim of this review is to update the evidence on associations between the use of these medications, weight gain, BMI changes, and major metabolic alterations in children and adolescents. This review was conducted following the PRISMA protocol and registered in PROSPERO under the number: CRD42024549448. The search was carried out in March 2024 using the terms "child," "adolescent," "weight gain," "metabolism disorders," and "antipsychotics," combined with the AND operator in the MEDLINE, Scopus, Cochrane, and PubMed databases. The main findings of this review included weight gain, increased BMI, and metabolic alterations, such as insulin resistance and increased abdominal circumference. The meta-analysis highlighted a positive association between one of the investigated second-generation antipsychotics and weight gain. Therefore, prescriptions may be accompanied by strict guidelines for nutritional monitoring and metabolic control interventions.