Antipsychotics are effective at suppressing
tics in
Tourette syndrome, but can cause side effects. At a single center, all children with
Tourette syndrome requiring
antipsychotics were systematically monitored for metabolic and neurologic side effects every 6 months. Seventy-three children were followed for a mean of 39.6 months. Most children were treated primarily with an atypical
antipsychotic. Thirty-three of 73 children (45%) developed
lipid abnormalities. Compared with population-based mean
lipid values for boys, total
cholesterol,
low-density lipoprotein,
high-density lipoprotein, and
triglyceride levels were significantly higher in our male sample (P < 0.0001). Girls had significantly lower
high-density lipoprotein concentrations (P = 0.0033). Thirty-six of 73 (49%) children demonstrated abnormal body mass index percentiles. The odds of having
lipid abnormalities were significantly higher in children with abnormal body mass indices (odds ratio, 6.0; 95% confidence interval, 2.15-16.7; P = 0.0004). Three of 73 children developed neurologic complications. Metabolic complications of
antipsychotics are common in children. These findings underscore the need to discuss benefits and risks before initiating
therapy, and the importance of routinely monitoring growth and
lipid profiles. Neurologic complications are uncommon, which is likely attributable to the primary use of atypical
antipsychotics in this setting.